Partial nail avulsion is an ingrown toenail surgery method that involves removing a portion of the toenail from its nail root. The technique is designed to treat ingrown toenails by removing the entire nail edge that is cutting into the sides of the skin.
There are various ways to perform a partial nail avulsion procedure. In the past, many would perform the traditional technique, which is very invasive and often done in an operating theatre. At Straits Podiatry, we perform our partial nail avulsion in the clinic using a minimally invasive method that takes approximately 30 minutes.
Many patients suffer repeated episodes of ingrown toenails despite having their nails treated or removed before. This is because the underlying nail root is still functional, and the nail continues to grow. It is important to understand that a partial nail avulsion alone does not prevent the nail from growing back.
Ingrown Toenail Management
The only proven long-term solution to recurrent ingrown toenails is to apply a chemical to destroy the nail root completely following a partial nail avulsion. This complete procedure is known as partial nail avulsion with chemical maxtrixectomy. This has proved to be highly effective with low recurrence rates.
Unlike the traditional methods, our partial nail avulsion with chemical matrixectomy procedure does not involve cutting your skin or any stitching. The procedure is also carried out under local anaesthesia, so it would be painless.
You might be wondering, “Wouldn’t there be a gap between the remaining nail and the skin?”. Yes, that is correct. However, this is the same as a wisdom tooth extraction, the gap will close once the wound has healed.
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The expected recovery for partial nail avulsion with chemical matrixectomy is between 2 to 4 weeks and is highly dependent on the age and health of the individual. Physical activity should be avoided following the procedure until otherwise advised.
Your podiatrist will also advise you on the management of the wound and suitable footwear options following the procedure. Generally, open-toed footwear is preferred to ensure minimal compression over the wound.
Partial nail avulsion is generally safe for young and healthy individuals suffering from recurrent ingrown toenails. However, there are conditions where we do not recommend this procedure.
Nail Bed Injury: Healing Time & Treatments
Ingrown toenail surgery is a procedure to treat patients with painful ingrown toenails. It is typically used on recurrent or severe cases of ingrown toenails. The name of the procedure we use is partial nail avulsion. It is a minimally-invasive technique that does not require any stitches or hospitalisation.
The duration of the procedure varies depending on the technique used. At Straits Podiatry, our partial nail avulsion procedure normally takes less than 30 minutes. Patients are able to undergo the procedure on the same day of their first appointment.
Ingrown toenail surgery may sound painful but it is not. The only part that involves pain is the anaesthetic injection, which would only take less than a minute. The remaining procedure would be painless and you will be able to walk right after. Most patients would not need painkillers after the procedure. In fact, removing the ingrown toenail using the procedure will already greatly relieve your pain.
Ingrown Nail Treatment And Surgery
For healthy individuals, recovery time after a partial nail avulsion procedure will range between 2 to 4 weeks. However, the duration may be longer for elderlies and patients with underlying health problems. Your podiatrist should assess your general health before recommending ingrown toenail surgery as a treatment option.
Similar to other medical procedures, there are potential risks for undergoing ingrown toenail surgery. Your podiatrist should advise and discuss these risks with you prior to the procedure.
Most patients that undergo ingrown toenail surgery are already suffering from an infection. In such cases, your podiatrist should advise you to obtain antibiotics after the procedure.
The Management Of Ingrowing Toenails
This depends on the procedure performed during the ingrown toenail surgery. A partial nail avulsion alone will not kill the root of the nail, and a new nail will grow back. A partial nail avulsion with chemical matrixectomy, on the other hand, will destroy the nail root and will stop the nail from growing back.
A nail avulsion would not affect most of your daily activities. However, it is important that we do not carry out other activities that can cause delays in wound healing. Generally, patients should avoid weight-bearing physical activities until the wound heals. We will also advise patients not to wear enclosed footwear for about a week.The nail is composed of a nail plate, nail matrix and nail bed. The nail bed is the soft tissue that lies below the nail and is essential for the growth of the nail. Nail bed injuries such as crush and avulsion injuries are commonly associated with injuries to the hands or fingertips.
Generally, nail bed injuries are caused from road accidents, sports activities, crush injuries (while handling tools), cutting (while handling machinery) and when the fingers get jammed in doors. The nail bed gets compressed between the hard nail on top and the finger bone below it.
Ingrowing Toenail Treatment
The symptoms of a nail bed injury are based on the type and severity of injury. A minor injury is characterized by swelling and pain. Moderate level of injury may cause collection of blood under the nail (hematoma) with deeper pain. Severe injuries can result in cutting of the nail, tearing and rupturing of adjacent skin and other structures and even fracture of bones under the nail.
When you present to a clinic with a nail bed injury, your doctor performs a thorough physical examination, sometimes under local anaesthetic. Your doctor may order X-ray if the nail bed injury is severe and has led to the fracture of a bone.
The goal of treatment is to restore the normal anatomy of the nail bed and the surrounding structures. A simple blood clot which appears as red or purple in colour will fade away gradually. Pain killers and antibiotics may be prescribed to alleviate pain and prevent infection. A hematoma can be drained by drilling a hole in the nail. In cases of severe injuries such as a cut nail or broken bones, surgery may be performed to suture the lacerations and align the bones with the help of splinting. Grafts may be used from another finger to replace the injured portion of the nail bed.
How Does Your Nail Look After Ingrown Toenail Surgery?
Nail bed injuries are mostly accidental. Care should be taken to avoid injury by handling things safely. Some of the precautions which can be taken to avoid the complications of nail bed injury are:A partial nail avulsion (PNA) provides a professional, safe and effective solution to the problem of frustrating and painful ingrown toenails. This is one of the most common procedures carried out in our clinic.
The procedure removes the small part of the toenail edge that is growing downwards/inwards, piercing the skin and causing your painful symptoms. We see fantastic results from this procedure and have great satisfaction with it, especially as many patients struggle with recurring ingrown toenails for years before having the procedure. Don’t worry – the procedure won’t leave your nail looking unsightly or abnormal. Instead, you’ll just have a very straight nail edge that is only slightly narrower than normal. This may be best described as “ oh, I see that now that you’ve pointed it out but otherwise I’d never have been able to tell ”.
The PNA procedure can be done with or without a step called a chemical matrixectomy, as described below, to destroy the nail growing cells present at the base of the nail. You’ll be able to discuss the best option for you with your podiatrist, but the primary difference is that the offending nail edge won’t grow back when we perform a chemical matrixectomy as part of your procedure, and it most likely will grow back without one. Without a chemical matrixectomy, it is difficult to predict whether the nail will regrow with a straight nail edge that will fix the problem, or if it will continue to become ingrown and cause you pain. We’ll go through everything including your expected outcome in the consultation to see if a PNA is the best option for you. If the nail has become severely deformed or if removing side sections would achieve an unsatisfactory result, you may choose to have a Total Nail Avulsion (TNA).
How To Fix An Ingrown Toenail Permanently[podiatrist Home & Surgery Tips!]
Recovery time is anywhere from two weeks to two months barring any complications such as infection. We provide you with all the dressings, topical antibacterial solutions and ointments, the post-op shoe and aftercare instructions, all tailored individually to your needs.
It is important to note that while the procedure, when completed with a chemical matrixectomy, does destroy the nail growing cells, there is always a chance that over time, these cells will heal and regenerate. Unfortunately, this is completely out of our control, as it depends completely on your body’s reparative response. We estimate permanent success in 4 out of 5 patients that we treat at Perform Podiatry. The way we distinguish cell regeneration vs. an ineffective procedure is the time between when symptoms develop. If your procedure was unable to completely remove the ingrown toenail, you should notice pain in the toe
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