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Nail Bracing

Discussion in 'General Issues and Discussion Forum' started by rachel.liminton, Jan 8, 2011.

  1. rachel.liminton

    rachel.liminton Active Member

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    Hi Folks,

    Just wondering what the current update is on Nail Bracing. Several of my clients do not wish to undergo nail surgery, but want relief from painful IGN or involuted nails......What is the latest research and is it effective? Grateful for your thoughts and wisdom

    Rachel x:sinking::craig:
  2. RCSupplies

    RCSupplies Welcome New Poster

    Podofix Nail Brace

    Irelands Leading Treatment For In-grown Toenails

    Made in Germany, Podofix is used for treating ingrown toenails/misshaped
    nails and cosmetic correction without surgery and without pain. It is also
    recommended for granular inflammation surrounding the nail.
    Podofix is an easy and quick choice in nail care, and it is the result of development
    by professionals over the course of many years.

    The Podofix active glue on brace can be flexibly adjusted to any nail
    Shape by comparison with conventional glue braces and glued on in a
    few seconds without any pre-tensioning.Only then is the brace
    continuously activated with the implanted wire and put under tension.
    This guarantees a perfect fit,secure support and maximum effect.
  3. Kenva

    Kenva Active Member

    As I recall, not much research is to be found on this topic.
    Problem seems to be to image the curvature of the nailplate in order to precisely measure the effect of nail bracing.
    We were thinking of trying an echo but never came around yet to play with it.

    We mainly still teach and use Ross Fraser techniques and has clinical reasonable results. If the patients doesn't mind paying for something that is more expensive then nailsurgery and probably less effective, I still go for it.

  4. footfan

    footfan Active Member


    I was looking to do research in this area over a year ago because everyone dismissed it as a dead , expensive , antique technology and simple PNA nail surgery was easier. This was anecdotal from my educators and frankly i hate superglue. Theres lots in the literature - even your friendly neales disorders of the foot p76-77 covers them. Bottom line theres little research that im aware of and you may want to contact RCSupplies and do a study for them
  5. rachel.liminton

    rachel.liminton Active Member

    Thank you for your response. I have several clients who are dead against nail surgery and would prefer a conservative management approach. I am inclined to agree that the best long term approach is a PNA or TNA, however if mitigating factors are such...... patient preference, vascular insufficiency etc... what other options are there??

    Whilst I was undertaking, my training a pod mentor (with 20+ years experience) undertook a case study of nail racing. The photographic results looked pretty impressive, together with the subjective response from the participant. However I am aware that as soon as the nail brace grew out the same problems recurred. It is a shame that very little research has been undertaken.....with podiatry being a very much evidenced based profession it would be great to access some objective research..... any one prepared to sponsor me?? :pigs::pigs:;)
  6. Bega Armando

    Bega Armando Welcome New Poster

    Aqui no Brasil trabalhamos com vários tipos de órteses ungueais, como o fio de aço com gancho, brackt ou elástico, além da fibra de memória molecular e das unhas em acrílico auto o fotopolimerizável.
  7. DTT

    DTT Well-Known Member

    Hi Rachel,

    I know the SMAE use nail bracing techniques and have done for many years.

    Whether they still do with the advent of nail surgery as part of their course I'm not sure but Mike Batt the principal I would have thought could give you all the evidence you need.

    Hope that helps
    Derek ;)
  8. footfan

    footfan Active Member

    How does this help when the entire thread is in English????
  9. MJJ

    MJJ Active Member

    According to Google Translate this is what was said:

    "Here in Brazil we work with various types of orthoses nail, as the steel wire with hooks, or elastic brackt, plus fiber and molecular memory of the nails in the light-cured acrylic self."

    Hope that helps. :wacko:
  10. davidh

    davidh Podiatry Arena Veteran

    Hi Rachael,

    I used nail braces before the advent of PNA's in the UK.

    I used the Ross Frazer technique. I can tell you from personal experience that it is time-consuming, that the braces sometimes become unattached, and that the results (my results anyway) were hardly ever permanent.

    You will probably get the same results (ie pull the plate away from the nail-bed, and perhaps obtain a little relief) from simply packing the nail.
  11. Ros the Pod

    Ros the Pod Active Member

    I tried the Ross Fraser method too with pretty much the same results. I also found it extremely fiddly to use.
  12. davidh

    davidh Podiatry Arena Veteran

    I joint-authored a Paper in The Foot (Churchill-Livingstone) about nine years ago. The subject matter was from a very ambitious Pod Student final-year project which examined cadaver terminal phalanges to see if there was any correlation between nail-shape and the shape of the terminal phalanx (in the frontal plane).

    I see there are a couple of refs to possible research into nail-bracing - it may be worth digging this Paper out for additional info. The authors were Holland and McMahon - I don't have the title immediately to hand I'm afraid, but if you're interested pm me.
  13. Cameron

    Cameron Well-Known Member


    Many moons ago a colleague called Arthur Hill (at Curtin University) wrote his Masters' thesis on the Nail Brace Technique and he certainly swore by the process. We were taught the procedure as students in the early 70s and I have certainly made several hundred since but overall was not all that impressed with the results. Whilst patients did find bracing an appropriate alternative to surgery (for them) the process was labour intensive and on every occassion it was eventually abandoned. At one time there was a heat forge (tongs) available which helped reshape growing nails. I always thought this approach had potential but have no actual hands on experience.

    To the best of my knowledge the transverse curvature of the nail is determined by the internal pressures over the root matirix combined with the curvature of the distal phalanx, if so the nail plate will continue to grow involuted - bracing at best may alleviate pressure on the sensitive sulci but only as a palliation.

    What say you?
  14. fishpod

    fishpod Well-Known Member

    nail bracing total cr-p taught by a womble nobody does this diabetic pts. pts with vascular insufficiency still have nail ops
  15. Cameron

    Cameron Well-Known Member


    On a few ocassions I have seen urea soaks being used to encourage the offending nail to shed. Where ther was no reported uticaria the procedure seemed to work.

  16. fishpod

    fishpod Well-Known Member

    yes have done this only 2-3 times in 27 years it works not a soak but using calmurid crean an occluding the nail
    Last edited: Feb 23, 2011
  17. davidh

    davidh Podiatry Arena Veteran

    The Paper was called An in-vitro Investigation into hallucal nail deformation .

    I had a quick trawl around the net this morning and couldn't find it.

    Terminal phalanges which exhibiited nailplate involution were selected and sliced across the middle of the nailplate in the frontal plane. I can recall very little else about the work. As I said, it was pretty ambitious for an undergrad degree, but I remember that it was done at Cardiff, so maybe someone remembers it?

    TS said:
    "To the best of my knowledge the transverse curvature of the nail is determined by the internal pressures over the root matirix combined with the curvature of the distal phalanx, "

    This is what we were taught, and what the study tried to shed some light on.
  18. zsuzsanna

    zsuzsanna Active Member

    Nobody has mentioned B/S Spangle Nail brace which is glued on the surface of the nail. Available from Canonbury and apparently very successful. I have talked to someone who uses it regularly with very good outcome.

    I have been taught the Ross Fraser technique but having experimented on myself and on my husband found it very uncomfortable. I have never attempted to use it on a patient.

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