Toe Nail Surgery: Details on Process, Healing, and Potential Complications
An ingrown toenail, also known as onychocryptosis, is a common foot problem that can cause significant discomfort. Fortunately, various surgical procedures are available to treat this condition, each with its own advantages and potential risks.
One of the most common surgical treatments is partial nail avulsion, where only the ingrown segment of the nail is removed. This procedure, which takes less than 30 minutes under local anesthesia, has a high success rate and a low recurrence rate. Often, chemical treatment of the nail matrix (root) using phenol is combined with this procedure to prevent regrowth of the ingrown portion.
For severe or chronic cases, or when the nail is thick or malformed, total nail avulsion might be recommended. This involves the removal of the entire toenail. While more extensive than partial avulsion, it can provide relief for those suffering from persistent ingrown toenails.
Another surgical option is matrixectomy, which involves the permanent destruction of the nail root to prevent recurrence. This can be done chemically or surgically and is often used for patients with frequent recurrences.
Recovery from these procedures is relatively quick, with the toe remaining numb for a few hours post-procedure. Mild pain, bleeding, and swelling are common in the first 24–48 hours. Recovery typically involves daily dressing changes, soaking the toe, applying antibiotic ointment, and wearing open or roomy footwear to reduce pressure. Patients should avoid heavy activity for a few days.
It's important to note that toenails grow back slowly; if the entire nail is removed, full regrowth can take 12 to 18 months, whereas smaller parts heal quicker.
Associated risks include infection if proper wound care is not followed, recurrence of the ingrown toenail, particularly if matrixectomy is not performed, persistent pain or swelling, and nail deformity, particularly after total avulsion or matrixectomy.
These procedures are generally safe with local anesthesia and have a high success rate when post-operative care instructions are followed carefully. General anesthesia is an option but requires more preparation and makes the surgery longer. Minor complications are common after nail surgery, but serious complications are rare.
Deep nail bed incision may be performed to relieve swelling or drain infected tissue. Ingrown toenail surgery is typically an outpatient procedure. It is crucial to keep the wound clean and dry, except during showering or cleaning, and to wear properly fitted shoes that are not too tight.
For those with a history of anesthesia complications or weakened immune systems, additional care may be necessary. A person's outlook for recovery from ingrown toenail surgery depends on their particular risk factors and the care they receive from a skilled, experienced podiatrist or orthopedic surgeon.
With proper medical care and diligent home management, the risk of complications following surgery can be reduced, and a full recovery with the regrowth of a healthy nail is more likely. If you are experiencing symptoms of an ingrown toenail or are concerned about your foot health, consult a healthcare professional for advice and treatment options.
[1] Mayo Clinic. (2021). Ingrown toenail. https://www.mayoclinic.org/diseases-conditions/ingrown-toenail/diagnosis-treatment/drc-20353347 [4] American Podiatric Medical Association. (2021). Ingrown Toenail. https://www.apma.org/learn/foot-health/ingrown-toenail [5] Cleveland Clinic. (2021). Ingrown Toenail. https://my.clevelandclinic.org/health/diseases/16890-ingrown-toenail
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