Abstract
Ingrowing toenails (IT) are a common disorder in which the the nail penetrates into the surrounding tissues, causing inflammatory reaction, pain and interference with daily activities. The aim of the study is to provide an algorithm treatment. Patients were divided into three groups according to the stage of IT at presentation. A total of 161 patients with 173 IT's were treated conservatively initially and then surgically if no recovery was documented. The surgical treatment included removal of the nail with the spicules which penetrate the soft tissues, excision of the nail wall, and curettage of the granulation and inflamed tissues. Ablation of the germinal matrix using phenol solution was performed only in recurrent IT's. Using our algorithm recurrent IT's were noticed in 13% and 19.4% of the patients who had stage II and III respectively. For optimal results IT should be staged and treatment tailored according to the algorithm.
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