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Ingrown toenail or overgrown toe skin?

Discussion in 'General Issues and Discussion Forum' started by Admin2, Mar 5, 2009.

  1. Admin2

    Admin2 Administrator Staff Member

    Members do not see these Ads. Sign Up.
    This caught my eye from the Canadian Family Physician:

    Ingrown toenail or overgrown toe skin?
    Alternative treatment for onychocryptosis

    Henry Chapeskie, MD CCFP FCFP
    Can Fam Physician. 2008 November; 54(11): 1561–1562
    The full article and description of the procedure is here
    A video of the procedure is here.
  2. MelbPod

    MelbPod Active Member

    well its good to think outside the square. Don't know if Im brave enough to give it a shot. Looked like alot of meat removed!
  3. cornmerchant

    cornmerchant Well-Known Member

    I note that figures of regrowth from surgery done by pods was not on the Cochrane review!

    I would dispute the figures and the cosmetic result- I rarely have regrowth from my nail ps and the end result is always good, with a shrinkage of all the tissue at the side of the nail. It is a non invasive proceedure- why would someone want to go through this alternative treatment which must be more painful and far more open to infection?

    I can see the advantage only in a young patient who did not want to lose the nail, and if their nail was similar to the nail in the picture, which was not very involuted, just wide.

  4. JMD

    JMD Member

    34% regrowth for GPs, 50% for general surgeons. The moral of the story is don't go near a GP or a surgeon for this type of procedure. I have completed over one hundred PNA's with phenolisation and there have been no regrowths.
  5. drsarbes

    drsarbes Well-Known Member

    They obviously have dismissed all Podiatric studies in their review of literature, assuming they did one.

    Sort of like reinventing the wheel.....I think round might work!
    Maybe they could think up a new procedure for Bunions, don't think ANYTHING has been done with those!!!!

  6. Franklin

    Franklin Active Member

    "Weightbearing caused the tissue to bulge over the side of the nail......."

    Are these tissue bulges not the phenomena which Henri L DuVries coined 'unguilabia' (singular: 'unguilabium') as far back as 1933 in the Chiropody Record? DuVries was an American chiropodist/podiatrist before he became an MD and finally an orthopaedic surgeon.


  7. bob

    bob Active Member

    In their spirit of 'thinking outside the box', perhaps they could amputate all the lesser rays to reduce the intermetatarsal angle and then amputate the hallux to reduce the HV angle?

  8. drsarbes

    drsarbes Well-Known Member

    Hi Eric:
    'unguilabia' (singular: 'unguilabium')

    I thought it was "dissatisfied Squamous"

  9. beekez

    beekez Active Member

    I think from memory that the cochrane review found that simple nail avulsion and phenolisation was more effective with less regrowth rates (and I would hazard a guess cost effectiveness) than more invasive surgical procedures.

    It also stated that the review didn't take into account procedures undertaken in the community by GPs and podiatrists and this would have an impact on figures. I have had had great success and minimal regrowth rates as it seems many others here have.

    I can see in some cases I have had wherethe nail is not the offending party (IMO) but tissue pressure on the nail with no deformity has caused issues (I have noticed it tends to occur in those with a late stance abductory twist in gait- just an observation)



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