Matrix excision vs orthonyxia for ingrown nails

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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.

 

What is orthonyxia?

 

OK - I googled it. Its 'nail bracing'.

 

The more interesting - and serious - question in this context is 'what is an ingrowing toenail?'

Bill Liggins

 

Perhaps someone with experience with nail bracing could give me a clear theory as to how it works for nail dystrophy?

How does it have an effect on germinal matrix cellular growth to provide a lasting solution to onychocryptosis? I don't quite see how this is possible, though I can perhaps get my head around how it might 'lift' the nail out of the sulcus (temporarily) due to Davis's law.


LL

 

Not a kinky request but..................

Any pics of a nail bracing thingmy wotsit.

I'm intrigued.

Thanks people,

PS. Doesn't Cameron K. usually know all about weird, kinky things?

Just a thought.

 

Hi all

Hmm Yes I used this in the long distant past on oc, involution, convolution and the like.

The study does not state which method of bracing was used .

The original consisted of spring wire of varying thicknesses (used depending on the torque required and nail type) which was formed in a curve at each end to "hook under the medial /lateral edge of the nail.

The wire would be then formed into a U or V shape midway between the two ends to allow adjustment of tension.

It was applied by hooking the two ends under the edges of the nail , pushing down proximally as far as possible, closing the U/V shape midway between the two ends to apply tension ( dorsiflex the nail at the edges and to push back the tissue away from the nail) and secure in place with acrytensil.

This would be repeated weekly to replace and re tension the brace.

The more modern version ( I think is still available from suppliers) consists of metal strips which are hooked under the nail and glued into position the principle being the same.

I know the SMAE swore by it as at the time they did not use LA and may still use the technique ??

The outcomes were successful to a degree but in my experience there were those with permanent damage to the groove through the infection or nail damage went on to require radical excision / wedge resection to resolve the condition.

Hope that bit of history helps if I can find any pictures I will come back

Cheers
Derek

 

Hi all

http://www.podiatrytoday.com/article/5163

Bit more info here

Cheers
Derek