ABSTRACT

The most frequent nail pathology of the hallux is the ingrown toenail. In our study, we evaluated Winograd’s partial matrix excision method as a treatment for unilateral ingrown hallux toenail.

Winograd’s partial toenail excision was performed on 239 patients (127 males, 112 females; mean age 37.4 years) with an ingrown toenail. Primary patient complaints included a painful hallux toenail, discharge, nail deformation, and difficulty walking. According to the Heifetz staging system, there were 62 patients evaluated as Stage l, 96 as Stage ll, and 81 as Stage lll. A total of 174 (74%) patients had discharge from infection. In infected cases, an antibiotic was administered until inflammatory signs and discharged ceased, at which time surgical treatment was performed. Patients’ duration to return to daily living and work, recurrence ratio, satisfaction, and cosmetic issues were evaluated. The mean follow-up time was 27 months (range: 14-45 months).

Patients returned to daily living in 10-15 days (mean 11.3) and to work in 8.7 days (range: 6-13 days). A total of 230 patients (96.3%) were satisfied with the procedure, and 231 patients (96.6%) were satisfied with the cosmetic results. Nine patients were dissatisfied with the surgical outcome, and eight patients who experienced recurrence were dissatisfied with the cosmetic results. None of the patients experienced deep tissue infections or neurovascular complications.

Winograd’s partial matrix excision method is a beneficial surgical procedure for ingrown toenail, resulting in low recurrence and high satisfaction rates. (JAREM 2014; 1: 7-11)

Keywords: Big toe, hallux, nail disorders, ingrown toenail surgery