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Chapter-314 Nail Disorders in Foot and Ankle

BOOK TITLE: Textbook of Orthopedics & Trauma (4 Volumes)

Author
1. Hardy Mark A
2. Prezioso Jennifer L
3. III Frank Luckino
4. Bumpus Kelly
ISBN
9789385891052
DOI
10.5005/jp/books/12869_315
Edition
3/e
Publishing Year
2016
Pages
12
Author Affiliations
1. Mercy Health Hospital Systems; Case Western Reserve University, School of Medicine; Mercy Health Foot and Ankle Residency; NOFA Foundation; NOFA International Fellowship, 36711 Amercian Way Blvd., Avon, Ohio, USA
2. Mercy Health Foot and Ankle Residency, 36711, American Way Blvd, Avon, Ohio, 44011, USA
3. Mercy Health Foot and Ankle Residency, Avon, Ohio, 44011, USA
4. Mercy Health Foot and Ankle Residency, 36711 American Way Blvd, Avon, Ohio, 44011, USA
Chapter keywords
Nail disorder, onychocryptosis, pincer nail deformity, trauma, chemical matrixectomy, laser therapy, excisional, subungual exostectomy

Abstract

This chapter focuses on the nail disorders in foot and ankle. Onychocryptosis is most common in teenagers and young adults during the second and third decades of life. One of the most common nail deformities is the pincer nail. It is defined as a transverse over-curvature of the nail that pinches the nail bed. This condition is often mistaken for an ingrown nail. Nail and nail bed injury can be due to direct trauma, degloving injuries, crush injuries, self-infliction, or iatrogenic trauma. Self-inflicted injuries due to onychophagia, nail biting, or picking can cause breakdown of ungualabia integrity, which can then be secondarily infected. It is not uncommon for patients to incorrectly trim their nails at an oblique angle, leaving a spicule that may become ingrown. Onychocryptosis is a clinical diagnosis. Etiology may be single or multifactorial. Conservative treatment can provide a cost-effective, noninvasive option for patients. Early in the presentation of an ingrown nail, wisps of antiseptic-soaked cotton can be packed between the nail fold and nail border to avoid skin penetration. Chemical matrixectomy, laser therapy, excisional, terminal Syme’s amputation and subungual exostectomy are the surgical management of onychocryptosis.

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