Ingrown Nail - Toe Surgery

An ingrown nail results from a nail growing into the surrounding skin (i.e. sulcus). This may occur at any of the toes but it usually affects the big toe. An Ingrown nail may be caused by improper trimming / cutting, injuries, infections, inherited nail deformities, or pressure (i.e. from footwear being too narrow at the toe box region of shoe). Ingrown nails are common and can occur at virtually any age.

♦ Symptoms:
Ingrown nails may cause pain at the top of the toe and / or all the way to the base of the toe. It is often worse while you are walking and wearing closed-in footwear. Sometimes discomfort can also occur whilst in bed due to pressure from bed sheets resting on affected area. Inflammation and / or infection may result from an ingrown nail. If there is an infection, you may have pus or redness around the area and the toe is usually very tender to touch.

♦ Treatment:
A conservative method is used on first assessment to free the offending edge from the side and if possible to pack the side with a material to help prevent further regrowth down the side. This method is usually very successful for minor ingrown nail problems with a sudden relief of pain gained by end of consult.

If the above method isn't successful and / or the problem reoccurs then nail surgery can be performed to permanently remove the offending side(s) thus resolving the problem.

•The above procedure is of a Partial Nail Avulsion (side of nail removed)

This procedure is performed under a local anaesthetic to numb the offending toe thus no pain is felt during the procedure. If one side or both sides of a nail(s) is removed this is known as a Partial Nail Avulsion (PNA). Here just the offending side(s) is removed whilst the remainder of the nail is left intact. If however the whole nails is problematic and / or there looks to be an increase chance of future problems with the nail, then the whole nail can be permanently removed. This is known as a Total Nail Avulsion (TNA) and this will leave the toe with no nail present. There is usually very little discomfort of the toe once the anaesthetic wears off.

• The above procedure is of a Total Nail Avulsion (whole nail removed)

The permanent removal of a side of a nail (PNA) or the whole / total nail (TNA) is beneficial if there is a history of reoccurrence of an ingrown nail. This reoccurrence not only contributes to repeated bouts of pain but also increases the chance of infection setting in and thus further complications arising.

♦ Prevention:
• Cutting your nails appropriately for your individual nail shape is a major preventable factor. You mustn’t cut down the side of the nail but just round the edge off.

• You mustn’t dig down the side of the nail as this often contributes to an ingrown nail or exacerbates the condition.

• Don’t wear shoes that are too narrow for your foot type.

• If a problem persists then make an appointment with a Podiatrist. Ingrown nails left too long usually get infected and make the condition more painful and more complicated to treat.