Nail brace vs surgery for ingrown toenails

NewsBot · Apr 28, 2015

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Nail Braces as an Alternative Treatment of Ingrown Toenails: Results From a Comparison with the Winograd Technique
Olcay Guler, MD, Hamide Tuna, MD, Mahir Mahirogullari, MD, Mehmet Erdil, MD, Serhat Mutlu, MD, Mehmet Isyar, MD
JFAS; Article in Press

Ingrown toenails are one of the most frequent nail disorders and can be treated with conservative or surgical approaches. Although discovered a long time ago, the available data are still very limited on the potential effectiveness of nail braces for ingrown toenail treatment. In the present retrospective study, we compared nail braces with surgical wedge excision using the Winograd technique with respect to the time to return to work, recurrence, interval to recurrence, and patient satisfaction. A total of 159 patients were divided into the nail brace (n = 74; mean age 29.51 ± 8.48 years) and Winograd technique (n = 85; mean age 26.95 ± 8.06 years) groups. In the nail brace group, the mean time to return to work (4.15 ± 1.07 days) was significantly shorter than that in the Winograd technique group (13.8 ± 2.26 days; p < .001). Patient satisfaction was significantly greater in the nail brace group (94.6%) compared with the Winograd technique group (82.4%; p = .018). Of the 159 patients, 6 (8.1%) in the nail brace group and 8 (9.4%) in the Winograd technique group developed recurrence; however, this difference was not statistically significant (p > .05). A statistically significant difference was observed in the mean interval to recurrence (12.46 ± 1.60 versus 13.24 ± 2.48 months, respectively; p = .031). The progression-free follow-up periods for the nail brace and Winograd technique groups were 15.45 ± 0.22 months (95% confidence interval 15.02 to 15.88) and 17.18 ± 0.29 months (95% confidence interval 16.61 to 17.84), respectively. We have concluded that the use of nail braces is an appropriate alternative treatment of ingrown toenails with high patient satisfaction, fast recovery times, and a low recurrence rate.
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Admin2 · Apr 28, 2015

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NewsBot · Mar 11, 2018

Efficacy of a new nail brace for the treatment of ingrown toenails
Che-Wei Liu, Yu-Chen Huang
JDDG: Journal der Deutschen Dermatologischen Gesellschaft

Background and objectives
Surgery is the mainstay of treatment for complicated ingrown toenails. However, alternative treatments using nail braces have been reported to show good efficacy. The objective of the present study was to investigate the efficacy of a new nail brace for the treatment of ingrown toenails.

Patients and methods
We conducted a retrospective study on patients with ingrown toenails treated at Wan Fang Hospital between June 1, 2015 and May 30, 2016. Ingrown toenails were classified into acute inflamed/infected (AI) and chronic dystrophic (CD) types. Using physician global assessment scores, the efficacy of nail braces for the two types of ingrown toenails was compared 1, 2, 3, and 6 months after treatment initiation and during the final visit.

Results
Twenty-one patients (42 sites) had CD-type ingrown toenails; 25 patients (36 sites) had ingrown toenails of the AI type. Of the affected sites, 81 %, 94 %, and 100 % showed an excellent or fair outcome at 1, 3, and 6 months, respectively. Recurrence rates were 10.3 %; complication rates, 7.7 %. While, in the first three months, AI-type ingrown toenails tended to achieve excellent results more rapidly than CD-type nails, outcomes were similar at six months.

Conclusions
Nail braces are an effective therapeutic option, particularly for CD-type ingrown toenails.
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NewsBot · Jun 28, 2019

Efficacy of a new nail brace for the treatment of ingrown toenails.
Liu CW, Huang YC
J Dtsch Dermatol Ges. 2018 Apr;16(4):417-423

BACKGROUND AND OBJECTIVES:
Surgery is the mainstay of treatment for complicated ingrown toenails. However, alternative treatments using nail braces have been reported to show good efficacy. The objective of the present study was to investigate the efficacy of a new nail brace for the treatment of ingrown toenails.

PATIENTS AND METHODS:
We conducted a retrospective study on patients with ingrown toenails treated at Wan Fang Hospital between June 1, 2015 and May 30, 2016. Ingrown toenails were classified into acute inflamed/infected (AI) and chronic dystrophic (CD) types. Using physician global assessment scores, the efficacy of nail braces for the two types of ingrown toenails was compared 1, 2, 3, and 6 months after treatment initiation and during the final visit.

RESULTS:
Twenty-one patients (42 sites) had CD-type ingrown toenails; 25 patients (36 sites) had ingrown toenails of the AI type. Of the affected sites, 81 %, 94 %, and 100 % showed an excellent or fair outcome at 1, 3, and 6 months, respectively. Recurrence rates were 10.3 %; complication rates, 7.7 %. While, in the first three months, AI-type ingrown toenails tended to achieve excellent results more rapidly than CD-type nails, outcomes were similar at six months.

CONCLUSIONS:
Nail braces are an effective therapeutic option, particularly for CD-type ingrown toenails.
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NewsBot · Jul 11, 2020

Efficacy of Nail Braces for Acute and Chronic Ingrown Toenails: A Prospective Study
Hsiao-Han Wang et al
Dermatol Surg. 2020 Feb;46(2):258-266

Background: Nail braces are an alternative treatment for ingrown toenails.

Objective: This study aimed to prospectively examine the efficacy of nail braces for treatment of acute inflamed (AI)-type and chronic dystrophic-type ingrown toenails.

Materials and methods: The authors conducted a prospective study of patients with ingrown toenails treated at Wan Fang Hospital between January 1, 2017, and July 31, 2018. Evaluation using physician global assessment scores and patient satisfaction questionnaires was performed at 1, 3, and 6 months after the start of treatment and during the final visit. Patient demographics, treatment courses, and outcomes were compared between the 2 types of ingrown toenails.

Results: Chronic dystrophic-type and AI-type ingrown toenails were observed in 25 (61 sides) and 28 patients (35 sides), respectively. Of the affected sides, 80.9%, 94.9%, and 100% achieved an excellent or fair result at 1, 3, and 6 months, respectively. Treatment duration and follow-up period were 179.2 ± 96.8 days and 281.6 ± 120.9, respectively. The recurrence rate was 7.4%. The treatment course and response were different between the 2 types of ingrown toenails.

Conclusion: Ingrown toenails could be effectively treated with nail braces with excellent outcomes, favorable patient satisfaction, and low recurrence rates.
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NewsBot · Nov 1, 2020

Polyethylene Nail Brace for Ingrown Toenails Treatment: A Randomized Clinical Trial
Salvador Márquez-Reina et al
Int J Environ Res Public Health. 2020 Oct 23;17(21)

Background: Onychocryptosis is one of the most prevailing onychopathies and one of the usual reasons for visiting podiatry clinics. In this research, we aim to evaluate the effectiveness of a procedure of nail reeducation technique via a strip of polyethylene in subjects with stage I or IIa onychocryptosis, in which pathological toenail curves are present. Methods: This research was a randomized clinical trial (ACTRN12615000834550). The sample was made up of 94 cases of stage I or IIa onychocryptosis, according to the Mozena classification. Briefly, 46 cases were treated with the combination of a spicule technique and nail brace with a polyethylene plastic strip, and 48 were only treated with the spicule technique. Results: The combination of the spicule technique and the nail brace technique with a strip of polyethylene had a significantly lower recurrence rate compared to that achieved with just the spicule technique, twelve months after the beginning of the study (N.S. = 0.000 for α = 0.05). The change in the nail width achieved with the nail brace technique, twelve months after the beginning of the study, was statistically significant (N.S. = 0.000 for α = 0.05). Conclusions: The recurrence rate of the spicule technique alone was significantly higher than the combined technique of spicule with nail brace. A nail brace with a strip of polyethylene reduces the recurrence rate of onychocryptosis.
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NewsBot · Dec 3, 2020

Polyethylene Nail Brace for Ingrown Toenails
Treatment: A Randomized Clinical Trial
Salvador Márquez-Reina et al
International Journal of
Environmental Research
and Public Health

Background: Onychocryptosis is one of the most prevailing onychopathies and one of the
usual reasons for visiting podiatry clinics. In this research, we aim to evaluate the effectiveness of
a procedure of nail reeducation technique via a strip of polyethylene in subjects with stage I or IIa
onychocryptosis, in which pathological toenail curves are present. Methods: This research was a
randomized clinical trial (ACTRN12615000834550). The sample was made up of 94 cases of stage I
or IIa onychocryptosis, according to the Mozena classification. Briefly, 46 cases were treated with
the combination of a spicule technique and nail brace with a polyethylene plastic strip, and 48 were
only treated with the spicule technique. Results: The combination of the spicule technique and the
nail brace technique with a strip of polyethylene had a significantly lower recurrence rate compared
to that achieved with just the spicule technique, twelve months after the beginning of the study
(N.S. = 0.000 for α = 0.05). The change in the nail width achieved with the nail brace technique,
twelve months after the beginning of the study, was statistically significant (N.S. = 0.000 for α = 0.05).
Conclusions: The recurrence rate of the spicule technique alone was significantly higher than the
combined technique of spicule with nail brace. A nail brace with a strip of polyethylene reduces the
recurrence rate of onychocryptosis.
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NewsBot · Jul 13, 2021

Risk factors for poorly controlled and recurrence-prone ingrown toenails treated with nail braces: A retrospective observational study of 238 cases
Hsiao-Han Wang, Yu-Chen Huang
Indian J Dermatol Venereol Leprol. 2021 Jul 7;1-5

Background: Nail braces are reportedly effective for treating both acute inflamed and chronic dystrophic type ingrown toenails.

Aims: In this study, risk factors for poorly controlled and recurrence-prone ingrown toenails treated with nail braces were identified.

Methods: We performed a retrospective study on patients with ingrown toenails between June 1, 2015, and May 31, 2018. The last follow-up date was January 31, 2019. Multivariate logistic regression was performed to evaluate the possible factors associated with poorly controlled status (ongoing paronychia during treatment) and recurrence.

Results: There were 120 (244 sides) and 118 patients (167 sides) with chronic dystrophic and acute inflamed type ingrown toenails, respectively. The mean treatment duration and follow-up period were 161.2 ± 98.3 days and 432.7 ± 320.9 days, respectively. Poor control and recurrence were seen in 7.3% (17/232) and 12.2% (27/221) of the patients, respectively. In the multivariate analysis, acute inflamed ingrown toenails, previous nail avulsion, proximal nail fold hypertrophy and more than one affected side remained significantly associated with poorly controlled ingrown toenails. Foot bone deformity was significantly associated with recurrence.

Limitations: This study was a retrospective study so that confounding factors such as comorbidities, body mass index, accompanying nail changes and lifestyle could not be evaluated.

Conclusion: Several risk factors related to poor control and recurrence were identified. Patients could therefore benefit from more suitable treatment plans with reasonable expectation.
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