UNASSIGNED: Onychocryptosis is a nail deformity that occurs when the side of the nail grows into soft tissue, which causes pain, sepsis and the formation of granulation. The aim of the study was to evaluate and compare different levels of kinesiophobia in subjects with onychocryptosis before and after surgery to eliminate this condition.
UNASSIGNED: A descriptive and observational study was conducted with a total sample size of 25 subjects with a mean age of 40.96 ± 18.25 years. The pretest sample was composed of the 25 subjects before the surgical treatment of onychocryptosis and the posttest sample was composed of the same 25 subjects after the surgical treatment of onychocryptosis. Kinesiophobia levels and total scores were self-reported using the Spanish version of the Tampa Scale for Kinesiophobia (TSK-11).
UNASSIGNED: The Wilcoxon test for related samples and the Mann-Whitney U test for independent samples were used to compare the results before and after the surgical treatment. It was observed that in all the items as well as in the total score, there were significant changes in the levels of kinesiophobia, after the surgical intervention for onychocryptosis (P < 0.05) compared to the levels before surgery, except for items 4 and 11 in which there were no significant differences (P > 0.05). Before surgery, 0% of the subjects with onychocryptosis reported not being afraid of movement, 16% reported mild fear of movement, 8% reported moderate fear of movement and 76% of the subjects with onychocryptosis reported severe and maximum fear of movement. On the other hand, 100% of the subjects did not report kinesiophobia after surgical treatment (P < 0.01).
UNASSIGNED: The levels of kinesiophobia were higher in the subjects with onychocryptosis compared to the subjects after having undergone surgery to eliminate onychocryptosis.

BACKGROUND: Ingrown toenails are a common pathology. Although a range of conservative and surgical measures are widely used for this condition, little is known about their use in practice. This study explored current practice relating to the treatment or management of ingrown toenails by podiatrists in the UK.
METHODS: A cross-sectional online survey (Qualtrics, Provo, UT, USA) conducted between March to June 2020 was distributed to practicing podiatrists treating or managing ingrown toenails in the UK.
RESULTS: A total of 396 practicing podiatrists responded (60.1% based in the private sector). The majority (88.6%) performed nail surgery most commonly (54.3%) less than five a month. Nearly all (95%) only performed nail avulsion with or without chemical matrixectomy, universally using phenol (97.2%). Application time and number of applications varied but was most commonly applied three times (61.5%) for a total of 3 minutes (75%). Aftercare varied considerably between public and private sectors, with public sectors offering fewer follow-up appointments.
CONCLUSIONS: Although there is a variation in clinical practice throughout the treatment pathway, almost all respondents offered nail avulsion with phenol matrixectomy, whereas very few provided incisional nail surgery. This data provides the most comprehensive description of how UK podiatrists conduct nail surgery for onychocryptosis.

暂无摘要。

BACKGROUND: A huge hypertrophic scar formation secondary to chronic ingrown toe nail mimicking tumor is a rare disease. It is not only causing concerns cosmetically, but also hindering normal daily activities physically and socially. In this paper, we present an unusual case of bilateral ingrown nails with different phases. One resulted in a large hypertrophic scar caused by stimulation from secondary to chronic ingrown nail.
METHODS: A 44-year-old man with a huge mass (7 × 4 × 8.5 cm) in his right great toe and inflamed ingrown nail in his left great toe visited the clinic. The mass in the right toe showed an irregular and bizarre shape with a stellate ulcer (2 × 2 cm) at the distal end. After removing an ingrown nail 3 years ago with minor repetitive trauma, self-managed wound has grown into a tumor-like mass, resulting in intolerable discomfort. In gross appearance, a stalk appeared to originate from the lateral side of the nail bed with the ingrown nail in the great toe showing inflamed medial and lateral gutter and causing redness and tenderness. Huge hypertrophic scar formation secondary to chronic ingrown toe nail mimicking tumor is a rare disease that is not only causing a cosmetic concern, but also hindering normal daily activities physically and socially.
RESULTS: Excisional biopsy was performed for both great toes. Biopsy confirmed chronic ulcerative inflammation with a hypertrophic scar. The resection site healed and persisted well at 12 months after surgery.
CONCLUSIONS: Our unusual case suggests that the natural course of an untreated ingrown toe nail may result in hypertrophic scar extending far to mimic tumorous conditions.

BACKGROUND: When performing nail surgery, clinicians must choose from a multitude of procedures and variations within each procedure. Much has been published to guide this decision making, but there are a lack of up to date robust systematic reviews to assess the totality of this evidence.
METHODS: Five databases (MEDLINE, Embase, CINAHL, Web of Science and CENTRAL) and two registers (Clinicaltrials.gov and ISRCTN) were searched to January 2022 for randomised trials evaluating the effects of a surgical intervention(s) for ingrown toenails. Two independent reviewers screened records, extracted data, assessed risk of bias and certainty of evidence. Data on co-primary outcomes of symptom relief and symptomatic regrowth were presented in our first paper. This paper presents data for the secondary outcomes and further discussion.
RESULTS: Of 3,928 records identified, 36 randomised trials were included in the systematic review. Healing time appears to be reduced with shorter application of phenol. A reduced healing time was also apparent was with the addition of curettage, although this may also increase the risk of post-operative bleeding and pain. Post operative bleeding was also reportedly lower in people who received local anaesthetic with epinephrine but no tourniquet. Use of phenol with nail bed excision may decrease the risk of infection. Lower pain scores were reported when using partial matrixectomy and surgical interventions with phenol. Shorter duration of pain was reported with phenolisation and wedge resection. Participant satisfaction was high overall.
CONCLUSIONS: This second paper reports secondary outcomes from a robust systematic review of randomised trials on surgical treatment of ingrown toenails. Despite the large volume of clinical trials conducted on the topic, few clinical conclusions can be drawn due to the poor quality of these studies. Further high-quality clinical trials are needed to answer fundamental questions in the surgical treatment of ingrown toenails.

BACKGROUND: Ingrown toenails are a common nail pathology. When conservative treatments are ineffective, a surgical approach is often utilised. Despite recent narrative reviews, there is a need for an up-to-date and rigorous systematic review of surgical methods for treating ingrown toenails.
METHODS: Five databases (MEDLINE, Embase, CINAHL, Web of Science and CENTRAL) and two registers (Clinicaltrials.gov and ISRCTN) were searched to January 2022 for randomised trials evaluating the effects of a surgical intervention(s) for ingrown toenails with a follow-up of at least 1 month. Two independent reviewers screened records, extracted data, assessed risk of bias and certainty of evidence.
RESULTS: Of 3,928 records identified, 36 (3,756 participants; 62.7% males) surgical interventions were included in the systematic review and 31 studies in the meta-analysis. There was very low quality evidence that using phenol with nail avulsion vs nail avulsion without phenol reduces the risk of recurrence (risk ratio [RR] 0.13 [95% CI 0.06 to 0.27], p < 0.001). No favourable effect was observed between chemical or surgical vs conservative management (0.55 [0.19 to 1.61], p = 0.280; 0.72 [0.33 to 1.56], p = 0.410), chemical or surgical vs other (e.g., CO2 laser, electrocautery) (1.61 [0.88 to 2.95], p = 0.120; 0.58 [0.25 to 1.37], p = 0.220), chemical vs surgical (0.75 [0.46 to 1.21], p = 0.230), surgical vs surgical (0.42 [0.21 to 0.85]), chemical vs chemical (0.19 [0.01 to 3.80], p = 0.280), surgical vs surgical + chemical (3.68 [0.20 to 67.35], p = 0.380), chemical vs surgical + chemical (1.92 [0.06 to 62.30], p = 0.710), local anaesthetic vs local anaesthetic + adrenaline (1.03 [0.22 to 4.86], p = 0.970), chemical timings 30 s vs 60 s (2.00 [0.19 to 21.41]) or antibiotics vs no antibiotics (0.54 [0.12 to 2.52], p = 0.430). Central toenail resection was the only procedure to significantly relieve symptoms (p = 0.001) but data were only available up to 8 weeks post-surgery.
CONCLUSIONS: Despite the high number of publications, the quality of research was poor and the conclusions that can be inferred from existing trials is limited. Phenolisation of the nail matrix appears to reduce the risk of recurrence following nail ablation, and with less certainty 1 min appears to be the optimum time for application. Despite this being a widely performed procedure there remains a lack of good quality evidence to guide practice.

BACKGROUND: The measurements of width index, height index, and curvature index were used for assessment of the curvature severity. Nevertheless, both sides of the nail root are buried subcutaneously, impossibility in measuring the width index correctly.
METHODS: We developed a technique to measure the index under high-frequency ultrasonography (HF-USG).
RESULTS: There was good agreement between the HF-USG index and the result examined after surgery.
CONCLUSIONS: The observation on HF-USG helps to distinguish between ingrown nail and pincer nail. The HF-USG index will be useful in the examination and measurement of nail roots buried subcutaneously or nail penetration under the hypertrophic lateral nail fold, and comparing the effectiveness among treatments for pincer nail objectively.

暂无摘要。

In the treatment of Onychocryptosis, chemical matricectomy with 88% phenol solution is one of the most common surgical procedures due to a recurrence rate of less than 5%, but it may produce a delay in healing time. The objective was to compare the healing time between phenol applications of 30 or 60 s.
A comparative, prospective, parallel, randomized, and blinded clinical trial was registered with the European Clinical Trials Database. Twenty-seven patients (54 feet) with 108 affected nail folds were randomized and treated with chemical matricectomy with phenol. Each hallux was randomly assigned to one of two groups (60 vs. 30 s phenolization). Each patient and one investigator were blinded to the phenol application time in each foot. The outcome measurements were healing time, recurrence, pain, post-surgical bleeding, inflammation, and infection rate.
The 30 s application presents a shorter healing time (14.93 ± 2.81 days vs. 22.07 ± 3.16 days; p < 0.001) with a similar recurrence rate (p = 0.99). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p > 0.05).
The 30 s phenol application time offers a shorter healing time than 60 s without affecting the effectiveness of the procedure, showing the same rate of complications.

暂无摘要。