Treatment of Ingrowing Toenails: Comparision of Surgery and Conservative Method Using Memory Alloy

Kim, Geon; Jue, Mihn Sook; Kim, Eun Jung; Park, Hyang Joon

Abstract

BACKGROUND
Many techniques for the treatment of ingrown toenails have been described in the medical literature. Surgical removal of the nail plate with partial matricectomy is associated with the lowest recurrence rates. Shape-memory alloy (KD wire) has shown promising results for the treatment of ingrown toenails. However, the results of long term follow-up or a comparison with surgical treatment have not been reported, and the adequate removal time of the wire remains unknown.
OBJECTIVE
To compare the results of surgical treatment using partial matricectomy (PM) to those of conservative treatment using KD wire (KD) and to determine the adequate removal time of the wire.
METHODS
The KD and PM groups were compared regarding pain relief, quality of life improvement, pain and discomfort during the procedures and 3 weeks after, improvement of nail index by using clinical photos, and patient's satisfaction with the treatments. The nail index improvement in the KD group was compared between postprocedural days 14 and 21.
RESULTS
Recurrence was higher (p=.039) in KD group (18.64%) than PM group (6.35%). Patient satisfaction was significantly better (p=0.025) in the PM group than in the KD group. Other parameters showed no significant differences between the two groups. Nail index improvement in the KD group was not significantly different between postprocedural day 14 and day 21.
CONCLUSION
Conservative treatment using the KD wire is as effective as surgical removal with partial matricectomy for the treatment of ingrown nails in pain relief, QOL improvement and nail index improvement, but has higher recurrence. The adequate application period of KD is 2 weeks.