Table 1 Therapeutic options according to classification of toe ingrowth [7]
Onychrocryptosis (toe ingrowth) | ||||
|---|---|---|---|---|
Stage I | Stage II | Stage III | Stage IV | Stage V |
Local irritation No infection, pus or granulation tissue. | Infection without a history of onychocryptosis. Pus and/or Granulation tissue | Infection with history of more than one episode of onychocryptosis. Pus/Granulation | Infective onychocryptosis with partial onycholysis of a single nail border. | Infective onychocryptosis with partial onycholysis of both nail borders. |
May Perform Cauterization | Do Not Perform Cauterization | |||
Treatment (Stage 1) | Treatment (Stage 2) | Treatment (Stage 3) | Treatment (Stages 4,5) | |
1.Self Treatment 2. Slant Back 3. Suppan 4. Chemical 5. Laser 6. Cold steel 7. Daily soaking | 1. Slant Back 2. Suppan 3. Chemical 4. Laser 5. Cold steel 6. Daily soaking | 1. Winograd 2. Chemical 3. Laser 4. Cold steel 5. Daily Soaking | 1. Remove offending nailborder or nail plate. 2. Resection of hypertrophic ungualabia. 3. Radiographs or magnetic resonance imaging is indicated in Chronic cases to rule out osteomyelitis. 4. Address osteomyelitis or periostitis. 4. Return for secondary stage procedure to include matrixectomy. 5. Resolve infection to return to Stage 1,2 or 3 for appropriate procedure. | |