Abstract
BackgroundCurrently, the management of ingrown toenail (onychocryptosis) ranges from conservative medical management to surgical treatment. Surgical management is typically performed as an outpatient procedure due to it numerous advantages such as the simplicity of the technique and the low incidence of postoperative complications. The most common postoperative complications are recurrences and surgical site infections, whereas gangrene complicating a surgical site infection has been scarcely reported. We are reporting a rare complication following ambulatory surgery untimely requiring amputation.Case presentationA twelve-year-old boy was referred to our orthopedic surgical department for a surgical site infection complicating an initial surgical management of a left ingrown big toenail leading to a dry gangrene of the affected toe. The gangrene toe was amputated under peripheral nerve block and the patient was discharged home the same day on antibiotics, analgesics and with sessions of rehabilitation and psychological support planned. The postoperative course was uneventful at 6 months of follow-up.ConclusionThe authors report this case to draw clinicians’ attention, especially wound care specialists, orthopedists and podiatrists to this rare but potentially debilitating disease.
Highlights
BackgroundThe nail may be subject to various congenital or acquired pathologies. The inesthetic nature and symptoms associated with these disorders generally lead the patients to consult
The management of ingrown toenail ranges from conservative medical management to surgical treatment
Pain is one of the major symptoms contributing to the consultation of patients suffering from nail diseases, ingrown toenails [1]
Summary
The nail may be subject to various congenital or acquired pathologies. The inesthetic nature and symptoms associated with these disorders generally lead the patients to consult. Case presentation A 12-year-old Cameroonian male adolescent with an uneventful past medical, family and psychosocial histories was referred to the orthopedic department of the National Social Insurance Hospital in Yaoundé, Cameroon for a surgical site infection of a left big toenail leading to a dry gangrene of the affected toe following surgical treatment for an ingrown toenail 36 h before his current hospital presentation. Persistent pain caused by the ingrown nail prompted the consult of a general practitioner who proposed a surgical treatment for the patient. His preoperative workups included a complete blood count, prothrombine time, partial thromboplastine time, fasting blood glucose and HIV tests which were all normal. After informing the patient’s family members about the pathology and obtaining consent
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