Congenital Ingrown Toenail of the Hallux

Abstract

Ingrown toenail in the infant is a rare entity that has only occasionally been discussed in the medical literature. At birth, or soon thereafter, children present with bilateral ingrown hallux toenails notable for pain, tenderness, erythema, purulence, and hypertrophy of the skin and fat of the distal end of the great toes extending over the dorsum of the nail plates. Inflammatory and infectious granulation tissue develops with time. We present a case series of 4 patients with bilateral congenitally ingrown hallux toenails. Conservative and surgical treatment modalities were used, with 3 of 4 patients undergoing wedge resection of the hypertrophic soft tissues at the distal end of the toes. There were excellent results in both feet of all patients with resolution of the condition and no recurrences in any patient. Clinical photos are provided for all patients. Ingrown toenail in the infant is a rare entity that occasionally requires surgical treatment. Excellent results are expected with wedge resection of the hypertrophic soft tissues.