title: Comparison of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion in the treatment of ingrown toenails.
abstract: The present retrospective study compared the efficacy of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion for the treatment of ingrown toenails (onychocryptosis). Two surgical methods were performed in 95 patients with a stage 2 or 3 ingrown toenail. Each patient was examined weekly until healing and then at 1, 6, and 12 months of follow-up. The outcomes measured were surgical duration, healing time, recurrence rate, the incidence of postoperative infection, and cosmetic appearance after surgery. Of the 95 patients (115 ingrown toenails) included in the present study, 39 (41.1%) underwent wedge resection (Winograd procedure) and 56 (59%), wedge resection plus complete nail plate avulsion. The mean surgical duration for wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion was 14.9 ± 2.4 minutes and 15.1 ± 3.2 minutes, respectively (p = .73). The corresponding healing times were 2.8 ± 1.2 weeks and 2.7 ± 1.3 weeks (p = .70). Recurrence developed in 3 (3.2%) patients after wedge resection (Winograd procedure) and in 4 (4.2%) after wedge resection plus complete nail plate avulsion. In addition, postoperative infection occurred in 3 (3.2%) patients after wedge resection (Winograd procedure) and 2 (2.1%) after wedge resection plus complete nail plate avulsion. Both of the surgical procedures were practical and appropriate for the treatment of ingrown toenails, being simple and associated with low morbidity and a high success rate. However, cosmetically, wedge resection (Winograd procedure) would be the better choice because the nail plate remains intact.
authors.affiliation: Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China.
authors.forename: Jia-Zhang
authors.initials: JZ
authors.lastname: Huang
authors.affiliation: Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China.
authors.forename: Yi-Jun
authors.initials: YJ
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China. Electronic address: jzdoccn@126.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009263:Nails, Ingrown / Q000473:pathology / Q000601:surgery*; D017060:Patient Satisfaction; D012008:Recurrence; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult
keywords: Winograd procedure; onychocryptosis; recurrence; surgery; treatment