Surgery diseases >>>> Onychogryphosis is an ingrown nail

Onychogryphosis is an ingrown nail.

Many people often have to deal with a very painful problem - the ingrowth of the edge of the nail plate of the first toe into the adjacent soft tissue (nail roll) - onychogryphosis.

The reasons for the ingrowth of the nail are associated with the incorrect method of cutting the nail plate (when the grown nail is cut in a straight line too low and its edges are not rounded, which causes the gradual ingrowth of the nail plate into soft tissues), or with the habit of wearing shoes with a very narrow toe (when the nail presses or digs into the soft tissues of the nail fold, causing chronic injury and changes the direction of growth), or with diseases, for example, fungal etiology (when the nail plate affected by the fungus is deformed and grows abnormally, while growing into the soft tissues of the finger). Sometimes an injury to the finger gives an impetus to the improper growth of the nail.

Signs of an ingrown nail are determined by pain in the area of the injured nail fold, the appearance of an inflammatory process, and then ulcers in the area of the nail growing into soft tissues. If the inflammatory process is started and an infection enters the wound, then this kind of injury may be accompanied by suppuration and granulation tissue proliferation in the area of injury. The toe swells up, and walking is painful, especially when it becomes difficult to walk in shoes.

It is not difficult to diagnose an ingrown nail injury , but, as a rule, to obtain a more complete picture of the spread of the inflammatory process, it is required to pass blood tests (especially for sugar) and take an X-ray of the finger to exclude damage to the bone tissue.

Treatment of an ingrown toenail is carried out by conservative methods (antiseptic foot baths, the application of anti-inflammatory and wound-healing ointments, the choice of open-toed shoes, while it is recommended not to trim the nail) or surgically (with a running purulent inflammatory process).

A solution of potassium permanganate, furacilin, chlorhexidine or herbal infusions can act as an antiseptic for the bath. Before applying the ointments, the finger must be steamed well so that the medicine contained in the ointment can penetrate the skin as deeply as possible. Ointments based on ichthyol or tar help well. The wound can be treated with proteolytic enzymes to accelerate the regeneration processes and remove necrotic plaque, if it begins to form in the suppuration zone.

Surgical treatment of an ingrown nail is based on partial or complete removal of the nail plate and simultaneous plasty of the nail roll, since the removal of the plate alone may not bring positive results, and the regrown nail will start to grow back into the soft tissues of the periungual roll. The plastic of the roller involves suturing the tissues of the finger in its lateral part, which allows the skin to stretch in such a way as to pull and turn the nail roller outward and prevent it from further contacting the lateral edges of the nail plate.

Granulation tissue is excised with a scalpel or vaporized with a laser.

If the problem of an ingrown nail is not treated in a timely manner, then such an injury can lead to complications (abscess, osteomyelitis, necrosis), especially against the background of developing diabetes mellitus or endarteritis. An extreme case of complication of an ingrown nail can be gangrene and amputation of the phalanx or finger completely.

To prevent ingrowth of the nail plate, choose shoes with rounded sufficiently wide toes and / or open toes. Try to trim your first toe at the edge of your toe (rather than below it) in a straight line and slightly rounding the corners.

There are special staples that are put on the nail and fixed on it. The staples slightly forcibly bend the nail plate and thereby move the lateral edges of the nail plate away from the soft tissues of the nail roll. This technique belongs to the category of non-surgical correction of an ingrown nail and has many modifications depending on the complexity of the case.