title: Partial matrix excision or segmental phenolization for ingrowing toenails.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Martini Hospital, Groningen, the Netherlands.
authors.forename: Carina L E
authors.initials: CL
authors.lastname: Gerritsma-Bleeker
authors.forename: Joost M
authors.initials: JM
authors.lastname: Klaase
authors.forename: Robert H
authors.initials: RH
authors.lastname: Geelkerken
authors.forename: Jo
authors.initials: J
authors.lastname: Hermans
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van Det
mesh_terms: 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
chemical_list: D000891:Anti-Infective Agents, Local; D019800:Phenol