[Clinical study on treatment of obstinate ingrown nail with distal phalanx of great toe and soft tissue orthopaedics].
OBJECTIVE
To investigate the clinical curative effect of distal phalanx of great toe and soft tissue orthopaedics for treatment of obstinate ingrown nail.


METHODS
From October 1997 to May 2006, 31 patients (38 nails) suffering from obstinate ingrown nail were treated by the distal phalanx of great toe and soft tissue orthopaedics. There were 23 males (27 nails) and 8 females (11 nails) with an average age of 17.5 years (12-28 years). The disease course was 2 years and 1 month to 14 years (average, 31.6 months). At the same time, thirty-eight patients with diseases of feet were selected randomly as controls. The depth of the nail groove was measured. The X-ray films were taken to calculate the rate of upward projection of tuberosity (r).


RESULTS
The depth of the nail and r value of 31 patients were 2.87 +/- 0.31 mm and 0.149 +/- 0.013, respectively. There were statistically significant differences when compared with control group (1.06 +/- 0.10 mm and 0.060 +/- 0.019) (P < 0.01). Thirty patients (37 nails) had a primary healing; 1 patient (1 nail) had a delayed healing. Twenty-nine patients (36 nails) were followed up for 8 to 29 months (average, 21 months). The appearance of the nail was satisfactory. No relapse occurred in all patients.


CONCLUSIONS
The upward projection of tuberosity of distal phalanx of great toe and deepened nail groove are the most important anatomical causes for ingrown nail. The distal phalanx of great toe and soft tissue orthopaedics is an effective treatment for obstinate ingrown nail.
Li
Jin
J
Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong Univercity of Science and Technology, Wuhan Hubei 430022, PR, China. lijin1973@hotmail.com
Hong
Guangxiang
G
Chen
Zhenbing
Z
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009263:Nails, Ingrown / Q000150:complications / Q000473:pathology / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D014034:Toes / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult