Newer Treatment For Ingrown Toenails – Once Spicule Out and Healed, Metal Brace It Straight = Orthonyxia

Spicule removal and later, metal bracing nail straight, has been shown equivalent to partial matrix excision

A recent review of foot problems recommended this treatment.

Original article here:

Partial matrix excision or orthonyxia for ingrowing toenails.
Kruijff S, van Det RJ, van der Meer GT, van den Berg IC, van der Palen J, Geelkerken RH.
J Am Coll Surg. 2008 Jan;206(1):148-53.

Protocol:

1) Spicule removed and healing allowed to occur – about a week
2)”A remanit metal thread with a thickness of 0.5 mm is bent in nail form, with an omega shape on the highest level and on both the lateral and medial sides, small U-shaped hooks, which are placed around both edges of the nail. The bent brace is put under tension and placed on the dorsum of the nail and attached with resin or gel.” [?crazy glue]

3) After 6 to 10 weeks, old removed and new brace inserted This is continued until “nail is shaped correctly.”

Resuming activites and hobbies was faster with splint.

Where can you get it?

It’s called the VHO-Osthold Brace and can be got here:

http://www.vho-osthold.com/en/produkte.php 

A different design  “NailEase” brace from here:

http://www.nailease.com/

Comment – Verdict seems that chemical destruction of nailbed is easier but there are going to be some cases…

addendum – here is a pic of putting pledget under corner of nail as a treatment for ingrown toenails: – needs to be put in under some form or anesthetic.

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3 Responses to Newer Treatment For Ingrown Toenails – Once Spicule Out and Healed, Metal Brace It Straight = Orthonyxia

  1. Kim says:

    is there anything that can stimulate growth ? I had the toenail removed on my left foot approx. 12 years ago and it grew back only to half of my nailbed and very thick. It was extremely painful for several years, if it was even bumped. I’ve had to file it down because of it being too high and painful to wear shoes. There seems to be a hollow area towards the middle of the nail bed. I would like to ba able to wear open toe shoes again without people staring…Thank you.

  2. admin says:

    To Kim:
    Sorry about your toe. Somethings that are important in this case:
    1) What is the diagnosis?
    – It could easily be assumed it is onychauxis (thickened nails) – used to be called horse nails here, because they occurred from the nail bed damage one receives after having one’s foot trampled over. Onychogryphosis occurs when it curves over like yours seems to do digging in mid nail. There are couple cases of this made worse by low thyroid.
    In:
    Diseases mimicking onychomycosis
    Miguel Angel José Allevato, MD
    Clinics in Dermatology (2010) 28, 164–177
    They talk about nail conditions mimicing toenail fungus and include issues such as:
    1) Paronychia – chronic soreness and redness of nail bed from yeast infection
    2) Psoriasis – causing pitting and dystrophic nails
    3) Lichen planus variant which can have thick nails, “longitudinal striata, cracks,and pterygium” (overgrowing nailbed).
    3) Peripheral vascular disease
    4) Rarely certain tumors
    It might be important to be sure just what you are dealing with and see a dermatologist.

    If indeed it is onychauxis (thickened nails), and it is digging in as you say, it might be worthwhile to see a podiatrist and see what s/he would suggest. I would think the nail should be removed and the nailbed destroyed with phenol – a simple procedure. Occasionally some spicules can grow back and need re-treatment.

    You do mention that you nave growth arrest of the nail and to that I have no answer except to assume that was part of the damage.

  3. Catherine Boumans says:

    My toenail fell of after a bike incident, and a new toenail was already growing underneath. It was growing fine until halfway my toe it dove into my flesh all along my toe, just not only the corners. It then was clipped and some flesh removed. A few milimeters later, it again dove into my toe. Again it was clipped. The podiatrist asked me if I wanted to have my toenail removed. I would not mind if that would solve the issue, but what if again the nail starts growing into the toe. Is there anything you could recommend. What are the disadvantages of permanent toe removal. Is there anything I could do to help it growing into a healthy nail ?
    ——————-
    From admin:
    – If you are diabetic, or have poor circulation in your legs, then all I can suggest is you get a second opinion.
    – incurving of twoenail, especially near its origin has been previously described:
    Journal of the American Academy of Dermatology Volume 58, Issue 6 , Pages 978-983, June 2008
    Retronychia: Proximal ingrowing of the nail plate
    David A. de Berker et al
    http://www.jaad.org/article/S0190-9622(08)00121-7/abstract
    Simple avulsion (removal) of toenail worked in most cases. though nailbed destruction was occasionally used as well.
    Good luck

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