Partial matrix excision or segmental phenolization for ingrowing toenails.
OBJECTIVE
To decide whether partial nail extraction with phenolisation or with partial excision of the matrix should be the standard treatment in patients with ingrowing toenails of the hallux.


METHODS
Randomized clinical trial with 12-month follow-up evaluations performed by observers who did not know which procedure was applied.


METHODS
Outpatient department of a surgical teaching hospital.


METHODS
Fifty-eight consecutive patients with a total of 63 ingrowing toenails were randomized.


METHODS
Thirty-four partial matrix excisions ("matrix" group) and 29 phenolizations ("phenol" group) were performed.


METHODS
Recurrence rate, postoperative morbidity (pain, wound exudates, and scar discomfort), and time to complete recovery (wearing shoes, performing normal activities/work).


RESULTS
Recurrences were seen after 7 procedures in the matrix group and also after 7 procedures in the phenol group, of which patients were symptomatic and required a second operation in 4 and 3 instances, respectively. None of the observed differences in wound healing, postoperative pain, and recovery were statistically significant.


CONCLUSIONS
Partial matrix excision and phenolization are equally effective in treating ingrowing toenails. Because the use of the toxic agent phenol should be avoided, partial matrix excision is the preferable procedure. But in view of the high recurrence rate, there is a need for further improvement of the treatment of ingrowing toenails.
Gerritsma-Bleeker
Carina L E
CL
Department of Orthopaedic Surgery, Martini Hospital, Groningen, the Netherlands.
Klaase
Joost M
JM
Geelkerken
Robert H
RH
Hermans
Jo
J
van Det
Rob J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006214:Hallux; D006801:Humans; D008297:Male; D008875:Middle Aged; D009263:Nails, Ingrown / Q000188:drug therapy* / Q000601:surgery*; D019800:Phenol / Q000627:therapeutic use*; D012008:Recurrence; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D019800:Phenol