Surgery for an ingrown toenail (or matricectomy)

Surgery for an ingrown toenail (or matricectomy)

An ingrown toenail is a very unpleasant foot condition that result from various causes. This section will help you assess the best treatment methods and discuss the advantages of surgery for an ingrown toenail.

What exactly is an ingrown toenail?

An ingrown nail (or onychocryptosis) can occur when a section of your nail penetrates the skin of the toe. This phenomenon mainly affects the big toe.

Fortunately, surgery for an ingrown toenail can quickly put an end to redness, inflammation, sharp pain and possible infection. It allows you to avoid more serious complications.

What types of people are more at risk?

Some people are more likely to suffer from ingrown toenails. These individuals may benefit from ingrown nail surgery to prevent their condition from deteriorating.

Those most at risk include:

  • Diabetics: they must consult a podiatrist as soon as the first symptoms appear in order to prevent their condition from deteriorating. In the most extreme cases, an ingrown toenail can cause bone infection.
  • Seniors: especially those with thick or curved nails. Their toenail deformation has a tendency to increase and their skin becomes more fragile with age.
  • Adolescents: as they are more active and experience major hormonal changes, adolescents’ feet sweat more. This excess humidity makes their skin more fragile to any impact in the toe area or improper nail trimming.

Nevertheless, the needs of patients vary according to individual cases. Thus, it is important to consult a professional to establish an action plan without delay.

Patient expectations following ingrown toenail surgery

The podiatrist must properly grasp the patient’s expectations regarding the upcoming procedure. It is also important to understand that surgery will not always restore all the original aestheticism to the toenail, but that our procedure is as aesthetic as possible.

Some cases will require major surgery that may make the nails smaller or result in them being partially removed. Regardless of the approach used, the goal of surgery is to relieve pain and preserve the best possible appearance of the nail.

When should a patient elect to have ingrown toenail surgery?

If you can’t put your shoes on, walk or play sports, you should elect to have surgery.

It is not normal to suffer from an ingrown toenail more than 2 weeks if you perform basic home treatments (foot baths and application of antibiotic cream). Your condition runs the risk of infection and further complications, and you must consult a professional!

What’s the best way to select a podiatrist for an ingrown toenail?

You can make a clear choice based on a few criteria. Ensure that your podiatrist can offer you the following advantages:

Personalized surgical treatment:

You must receive personalized treatment. And good follow-ups and availability on your podiatrist’s part are also important.

Human surgical treatment:

It is important to be supported by a professional and welcoming team. The ties that you form with your podiatrist must be strong and you must have confidence in them. Mutual respect is of primary importance. Your podiatrist must display compassion and monitor your progress before, during and following your ingrown toenail surgery.

Your PiedRéseau clinics offer the following advantages:

  • Easy access to a clinic near you
  • Quick contact with a podiatrist
  • Rapid intervention in the event of any complication
  • Clear answers to your post-surgery questions

There’s always a PiedRéseau clinic easily accessible throughout Québec.

How do we evaluate whether a patient requires ingrown toenail surgery?

Your PiedRéseau podiatrists are professionally trained to perform ingrown toenail surgery. They can perform all procedures to help with your toenails.

L’histoire du patient est très importante

Le podiatre utilise l’historique du patient pour déterminer les circonstances ayant causé l’ongle incarné. Il peut notamment s’agir d’un problème chronique. En effet, certaines pathologies font en sorte que les ongles du pied peuvent se déformer ou épaissir avec le temps.

Clinical examination

This is used to assess whether you are a candidate for surgery. During this portion of the examination, the podiatrist takes several things into consideration:

  • Your surgery history
  • Your health records
  • Your medication
  • Your allergies

In addition, a vascular assessment of your feet will be conducted to ensure optimal healing.

An X-ray may be required to verify whether the bone under the nail has been indirectly damaged due to your condition.

Conservative treatment methods

Before beginning surgery for an ingrown toenail, it is very important to identify what you have already tried and what we can try together. For example:

  • Traditional toenail trimming performed by a podiatrist
  • Specialized nail trimming
  • Foot baths with massage to release the nail
  • Application of a nail strip to straighten some nails
  • Surgeries during hospital visits

However, sometimes the situation has advanced so much that it becomes impossible to soothe the condition with conservative treatment methods. This is when matricectomy becomes the only solution to the problem.

Advantages

Matricectomy comes with several advantages:

  • Accessible
  • Rapid
  • Cosmetic
  • Almost painless

Choosing PiedRéseau comes with the following advantages:

  • Proper follow-up
  • Expertise
  • Increased availability

The podiatrist takes into account the patient’s medical history to determine the circumstances that caused the ingrown toenail. This may be part of a chronic problem. Indeed, some pathologies cause toenails to become deformed or thicken over time.

Ingrown toenail surgery (partial matricectomy)

Ingrown toenail surgery in a podiatry clinic is minimally invasive. It allows you to effectively and definitively eliminate the pain while preserving the aesthetic appearance of your toes. The operation is performed under local anaesthesia. This ensures your toe will have little or no pain following surgery.

Below are the various steps of the procedure:

At the clinic

The operation can be performed with or without a tourniquet.

  1. Anaesthesia of your toe (from 1 to 6 hours, depending on each case)
  2. Cleansing and disinfecting of your toe
  3. Gentle release of the nail with a spatula
  4. Removal of part of the nail (usually 2 to 5 mm)
  5. Removal of infected area with phenol solution
  6. Rinsing the area with saline or alcohol solution
  7. Application of antibiotic cream, gauze and dressing

You can return home shortly following the clinical procedure.

At home

Keep your dressing dry for 24 to 48 hours. It is normal to feel tingling and tenderness following the operation, after the anaesthetic stops working.

Chronological steps of ingrown toenail surgery

Here are all the steps of your care, up to surgery:

Pre-surgery assessment

This step is completed before the procedure so that you understand the treatment plan and can make a clear and informed choice.

Surgical preparation

Your foot must have been bathed within the last 24 hours.

The day of surgery

If recommended, you must have taken your medication one hour prior to ingrown nail surgery.

Once at the clinic, the team will start your surgical preparation. You will be cared for and maintained in a comfortable state throughout the process. Normally, foot procedures are performed under local anaesthesia and, in rare cases, with mild sedation via oral tablets.

Follow-up visits and home care

Each procedure requires special care at home. Your podiatrist will clearly explain what you should do at home. Normally, you will be given a small checklist notebook for the home. And a follow-up appointment with your podiatrist will be conducted within 7 to 14 days.

It is recommended that you don’t wet your foot within the first few hours following surgery.

How long does it take to heal from ingrown toenail surgery?

Healing normally lasts from 2 to 4 weeks. The wound does not normally restrict the patient from practising their daily activities, but regular attention is required to ensure proper healing.

When can I recommence my daily activities?

In most cases, you can begin your daily activities again as early as the second week, practically painless.

Follow your instructions to the letter!

It is very important that you follow the pre-surgery and post-surgery instructions to the letter. Your actions following surgery will have a direct impact on your recovery and the success of the procedure.

The disadvantages of ingrown toenail surgery at your podiatrist's

They last a short time and are much less than the limitations caused by an ingrown toenail in the long term:

  • You must disinfect the wound for a 2 to 3 week period.
  • Some shoes can cause pressure and sensitivity in your toe during the healing process.
  • You cannot play sports the first week following the operation. Sports activities should then be limited until complete recovery. Practising sports can slow the healing of your foot.

In short, these are but small inconveniences compared to an ingrown toenail.