Ingrown Nail Surgery

Ingrown toenails (known as onychocryptosis) make up about 20% of all foot and ankle issues. This condition occurs when the nail plate pushes in and aggravates surrounding skin and tissue, resulting in pain, inflammation, redness and can lead to infection. In most cases, this affects the big toe, but sometimes it can also occur in your lesser toes as well.

Causes of Ingrown Nails

  • Improper cutting technique (aggressive cutting down corners)
  • Curved nail shape
  • Repeated trauma to the feet
  • Shoes with small, tight toe boxes
  • Fungal infections
  • Genetic

However, not all ingrown toenails require surgery. It’s best to book a consultation with your podiatrist first for them to assess whether it can be treated and managed conservatively before progressing to surgery.

There are many types of surgeries to treat onychocryptosis. These include:

  • Wedge Resection
  • Partial Nail Avulsion
  • Total Nail Avulsion
  • Rotational Flap

Surgery would be best considered if:

  • You chronically get infections due to ingrown toenails
  • Impacts your choice of footwear due to pain
  • Conservative treatment has failed to control/maintain it

Our preferred procedure at Crows Nest Podiatry is a PNA with Chemical Matrixectomy under a local anaesthetic.  Studies have shown that this method has a 94% success rate, with 4% non-ingrown regrowth of the nail and a 2% recurrence rate making it the most effective, and least invasive surgery option available.

Further benefits of a PNA are that it’s a quick procedure, only lasting 45-60 minutes. A normal nail is left after healing and hence, there is a quicker recovery time.

PNA surgeries normally require 45 – 60 minutes. First a local anaesthetic is administered to numb the toe. The nail plate is then released from the nail bed, cut out and the surrounding tissue assessed. If needed, your podiatrist will clear out any debris, scar tissue, or extra tissue growth before using phenol to chemically burn the nail matrix. This is what prevents the nail from growing back.

After flushing the phenol with saline, your toe is dressed using antibacterial dressings and bandages. Your podiatrist will then educate you on how to take care of your toe/s and book you in for follow up appointments at 3 days post-op and 1-week post-op to monitor and assess the surgical site.

Make sure to wear open toed sandals or thongs to the appointment and have someone to take you home afterwards!

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