Ingrown Toenail Surgery

If you have suffered from a recurring ingrown toenail you can attest to the increasing discomfort and frustration they provide! Ingrowing toenails are a common toenail problem and can be extremely painful and if left un-managed or un-treated can become infected and may require surgery. To learn more about ingrown toenails please read our previous blog.

Ingrown toenail surgery is a procedure commonly performed by podiatrists to effectively remove and an ingrowing toenail and never have the nail grow back! Does this sound too good to be true??? Well…studies comparing a variety of surgical techniques performed by different practitioners (GPs, Surgeons, Podiatrists and Podiatric Surgeons) have determined that if performed correctly and with the appropriate level of follow up, the partial nail avulsion technique performed by podiatrists is the most successful in eradicating an ingrown toenail and poses the least risk of possible re-growth.

Why would I need ingrown toenail surgery?

One of the main reasons nail surgery would be performed is to manage and eliminate pain. Other reasons ingrown toenail surgery would be recommended is to prevent recurring infections, manage recurring pain with pressure from footwear or correct some nail deformities. Before looking at surgery as a suitable treatment option, your podiatrist will consider other more conservative treatment options but when this condition limits your ability to work, attend school, play sports or participate in the activities you enjoy, nail surgery may be the best solution.

Who performs ingrown toenail surgery?

Your podiatrist is not only trained but highly skilled in nail surgery. The type of procedure performed by podiatrists is called a “Partial Nail Avulsion.” This procedure is also known as a PNA or nail root and matrix resection and is a relatively minor nail surgery performed in your podiatrist’s consultation rooms.

How long does the Surgery take?

The procedure takes approximately one hour and you should be able to walk after the surgery. Excessive activity including sport is not recommended as it can promote bleeding and affect the success of the surgery.

What does this surgery involve?

To determine you suitability for this type of surgery your podiatrist should complete a short assessment covering medical history and assessing any possible contraindicating medications you may be taking. Often this assessment will include an assessment of the blood flow to your feet.
Nail surgery is performed under the use of a local anaesthetic. Once your toe is numb the area is prepared using an antiseptic solution such as betadine and a tourniquet is used to control and limit bleeding, this is like a tight elastic band. The section of ingrown nail is then gently lifted from the nail bed and trimmed away and the offending portion of nail is removed in one piece. At this point a chemical is used to cauterize the nail bed and nail matrix to prevent the risk of regrowth. Following the completion of the procedure the tourniquet is removed and a sterile dressing is applied. You are able to walk immediately following the surgery however it is highly recommended you have a lift home.

What happens after the procedure?

Re-dressings at home and a few consultations with your podiatrist are required over the two to three weeks following the procedure. For the first few days after the procedure mild pain relief medication, the use of open toed shoes and activity modification may be necessary; however interference with day to day activities is generally minimal.

Are there any complications?

As with any surgical procedure there is some risk of complication, however this procedure is known to be very safe and effective.
The most common side-effect is post-operative infection in the short term. The risk of infection can be minimised through good post-operative care and your podiatrist will advise and assist with your situation. The technique used is extremely comprehensive and the possibility of re-growth is minimal.

Management:

Regular visits to your podiatrist can manage and prevent ingrown toenails, alleviate pain, and help keep you on your feet and mobile.

References:

Rounding, C & Bloomfield, S (2008). Surgical treatments for ingrowing toenails (Review). The Cochrane Libratry, 2008 Issue 4.