单侧甲沟切除并重建浅甲沟治疗嵌甲性甲沟炎

目的 总结单侧甲沟切除并重建浅甲沟治疗嵌甲性甲沟炎的方法.方法 单侧甲廓、甲板、甲基质矩形切除并重建浅甲沟.结果 治疗嵌甲性甲沟炎64例,仅2例复发,总有效率97％.结论 该法简单易行,操作方便,对趾甲和软组织损伤小,患者痛苦小,并发症少,治愈率高.     

甲床部分切除联合甲沟重建治疗嵌甲性甲沟炎

目的探讨甲床部分切除联合甲沟重建治疗嵌甲性甲沟炎的临床疗效。方法对48例（51足）嵌甲性甲沟炎采用甲床部分切除联合甲沟重建手术治疗,手术前0.5%碘伏浸泡患趾,切除增生的肉芽组织及病变甲沟,纵形切除约1/5甲床,重建甲沟,术后加压包扎,抗炎换药治疗。结果本组均获随访,随访时间4个月～2年,术后复发1例,二次手术后痊愈;术后感染2例;其余患者甲沟重建外观美观、无复发,患者满意。结论嵌甲性甲沟炎采用甲床部分切除联合甲沟重建治疗,可以取得满意的疗效。     

甲母质部分切除联合甲沟重建治疗嵌甲性甲沟炎

目的探讨甲母质部分切除联合甲沟重建治疗嵌甲性甲沟炎的疗效。方法将嵌甲性甲沟炎30例随机分为对照组和治疗组,每组15例。对照组给予单纯拔甲+局部切开换药治疗。治疗组予以甲床、甲母质部分切除联合拔甲术、甲沟重建术治疗。比较两组患者的临床疗效。结果治疗组愈合时间明显短于对照组,复发率及伤口细菌检出率明显低于对照组,差异有统计学意义(P0.05)。结论采用甲母质部分切除联合甲沟重建治疗嵌甲性甲沟炎,疗程短、复发率低,值得临床选用。     

甲基质联合甲沟切除重建术治疗嵌甲性甲沟炎

目的：探讨一种治疗嵌甲性甲沟炎的方法并讨论其临床意义。方法：切除嵌甲、炎性肉芽组织及部分患趾甲基质,同时重建甲沟。结果：重建甲沟形态良好,效果满意,复发率低。结论：甲基质联合甲沟切除重建术是治疗嵌甲症的理想方法。     

微创甲基质楔形切除术治疗顽固性足拇趾嵌甲性甲沟炎

目的探讨微创甲基质楔形切除术治疗顽固性足拇趾嵌甲性甲沟炎的临床效果。方法自2010年1月至2016年12月,对32例36趾顽固性足拇趾嵌甲性甲沟炎患者采用微创甲基质楔形切除术治疗。先切开甲根部少许皮肤,拔除宽约3 mm的纵行条状嵌入侧的趾甲,再楔形切除甲根部部分甲基质,直接缝合皮肤。结果所有患者术后伤口均一期愈合,无切口感染等并发症发生。随访4～24个月,甲体外形生长良好,无明显畸形,甲沟炎均无复发,治愈率为100%。结论采用微创甲基质楔形切除术治疗足拇趾顽固性嵌甲性甲沟炎,是一种简单、实用且较理想的手术方式。     

改良的甲板及甲基质部分切除治疗嵌甲性甲沟炎

目的探讨改良的甲板及甲基质部分切除治疗嵌甲性甲沟炎的临床疗效。方法选择2012年7月-2016年3月收治的86例95趾足部嵌甲性甲沟炎患者,采用患侧部分拔甲、甲基质部分(约1/5)切除、甲床外翻抬高、增生肉芽组织切除联合甲襞修整方法治疗,观察术后疗效。结果患者术后愈合佳,除3例术后创面感染,再次清创后愈合,其余切口均Ⅰ期愈合。81例获随访,随访时间10个月~4年,平均12.4个月,患者趾甲外观完整,患趾感觉及运动功能正常,无复发,无并发症、后遗症发生。结论该术式是目前治疗嵌甲性甲沟炎的有效方法之一,手术时间短、微创、方法简单可行、恢复快、治愈率高、远期疗效确切,尤其不影响甲部整体外形美观,患者易于接受,值得推广。     

甲板、甲基质部分切除联合甲沟重建治疗重度嵌甲症

我科自2000年1月至2007年4月采用患侧甲板、甲基质部分切除联合甲沟重建治疗82例躅趾重度嵌甲症,取得满意疗效。 1临床资料 本组82例,男53例,女29例;年龄16-52岁,平均为26-2岁。部位：右足蹲趾36例,左足躅趾42例,双足躅趾4例。外侧甲沟炎54例,内侧甲沟炎42例,其中包括单足双侧甲沟炎8例,双足双侧甲沟炎2例。     

嵌甲性甲沟炎患者采用甲母质、甲床部分切除联合甲沟重建术治疗疗效及减轻疼痛的作用分析

目的探讨嵌甲性甲沟炎患者采用甲母质、甲床部分切除联合甲沟重建术治疗疗效。方法将2015年6月至2016年6月收治的行甲母质、甲床部分切除联合甲沟重建术治疗的嵌甲性甲沟炎患者49例作为研究观察组,另选取同期于医院行全甲拔除术的嵌甲性甲沟炎患者49例作为对照组。记录两组患者术后愈合时间和一次性治愈率及换药次数;术后随访8个月,评价两组患者疼痛、感染、畸形及复发率。结果观察组患者术后愈合时间、一次性治愈率及换药次数分别为(15.1±1.4)天、91.84%(45/49)、(6.2±2.1)次,明显优于对照组(25.3±3.2)天、67.35%(33/49)、(9.7±3.2)次,P0.05;随访8个月,观察组患者术后疼痛评分平均为(3.9±1.3)分,明显低于对照组(5.3±2.2)分,t=3.83,P=0.00;观察组术后感染率、畸形率分别为2.04%(1/49)、0.00%(0/49),明显低于对照组18.37%(9/49)、12.24%(6/49),χ~2=(7.12,6.39),P=(0.00,0.01);观察组治愈后复发率2.22%(1/45)明显低于对照组15.15%(5/33),χ~2=4.48,P=0.03。结论甲母质、甲床部分切除联合甲沟重建术治疗嵌甲性甲沟炎患者疗效显著且可减轻术后疼痛及减少复发,因此值得深入研究。     

微创甲母质刮除术治疗嵌甲性甲沟炎206例术后疗效调查

目的：采用减少创伤,清除仅与疾病有关的肉芽、甲板、甲母质(nail matrix,或甲基质onychostroma)等病变组织术式治疗嵌甲性甲沟炎,并随访评估疗效。 方法：2010年-2013年6月,门诊手术治疗206例嵌甲性甲沟炎患者。术中剪除病变侧甲板3-4mm,并刮除与之相关的甲母质,刮出炎性肉芽,术后换药。 结果 术后随访6月-2年,复发13例,术后3月复发人数最多,复发率6.3%,优良率：93.6% 结论：微创甲母质刮出术,创伤小,手术简单,疗效满意,建议推广。     

嵌甲性甲沟炎的治疗

甲沟炎一般是因甲廓部的倒刺、甲廓损伤或慢性刺激导致细菌侵入皮下引起,也可由指（趾）甲长入甲沟内引起,前者可经过清创、换药、切开引流等措施治疗,对于后者引起的甲沟炎,传统的治疗方法往往是拔甲,而拔甲术后效果持续时间较短,待到新趾甲长出又会引起甲沟炎,需再次行拔甲术,临床上经常看到反复拔甲1～4次仍未痊愈的患者。笔者近3年来对嵌甲性甲沟炎患者采取切除嵌甲侧少部分趾甲、甲床及部分侧甲廓、对应的少部分甲母、甲沟内炎性组织,术后取得良好的治疗效果,笔者称其为嵌甲整形术,可一次性治愈嵌甲性甲沟炎。     

垂直半褥式缝合结合甲沟重建治疗嵌甲型甲沟炎的临床观察

【摘要】〓目的〓探讨垂直半褥式缝合结合甲沟重建手术治疗足复发性嵌甲型甲沟炎的临床疗效。方法〓选择2011年6月~2013年6月我院收治的复发性嵌甲型甲沟炎患者,包括采用垂直半褥式缝合结合甲沟重建术治疗64例(垂直半褥式缝合组),采用部分或全拔甲术治疗64例(拔甲组)。比较两组术后12个月临床疗效。结果〓采用垂直半褥式缝合治疗的患者中复发6例(9.375%),拔甲组患者复发19例(29.687%),并且在疼痛比较、感染及畸形程度等比较上两组差异具有显著性意义(P<0.05)。结论〓垂直半褥式缝合结合甲沟重建治疗复发性嵌甲型甲沟炎疗效可靠,复发率低。     

100例嵌甲患者的手术治疗效果分析

目的：通过对100例嵌甲病人的手术治疗探讨部分甲皱襞和甲床切除术治疗甲沟炎的疗效。方法：对三种类型共100例甲沟炎病人施以部分甲皱襞和甲床切除术加以治疗。结果：共治疗100例,99治愈（其中80例一期愈合,19例感染,经引流、换药后二期愈合）。随访2～8个月,平均5个月,一例复发,无复发患者对趾甲外形满意。结论：嵌甲是引起甲沟炎主要的原因,部分甲皱襞和甲床切除术对治疗各类型嵌甲时手术操作简单,效果满意,复发率低,同时一定程度上有美甲作用。     

48例嵌趾甲的病因分析及手术治疗

目的探讨趾嵌趾甲的病因,介绍一种新的手术治疗方法。方法对1997年10月至2003年10月我科收治的趾嵌甲患者48例51趾患者均进行手术治疗,咬除末节趾骨末端爪粗隆部分,梭形切除趾端及趾甲两旁软组织。随访观察趾端及趾甲的外形、了解嵌甲复发情况。结果所有病例平均随访26个月,47例50趾嵌甲治愈,1例1趾复发,经再次手术后治愈。结论趾末节趾骨爪粗隆突上翘是形成趾嵌甲的原因之一,咬除趾骨末端爪粗隆并梭形切除趾端及甲根两旁软组织是治疗嵌甲的一种有效方法。     

Treatment of Recurrent Ingrown Great Toenail Associated with Granulation Tissue by Partial Nail Avulsion Followed by Matricectomy with Sharpulse Carbon Dioxide Laser

BACKGROUND: The effectiveness of partial nail avulsion followed by matricectomy with carbon dioxide (CO2) laser for the treatment of ingrown great toenails remains unclear. OBJECTIVE: This study sought to determine the effectiveness of partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of recurrent ingrown great toenails associated with granulation tissue. MATERIALS AND METHODS: Fourteen patients with a total of 18 recurrent ingrown great toenails were randomly selected for participation in this study. Partial nail avulsions followed by matricectomy with sharpulse CO2 laser were performed on the involved nails. After at least 6 months, we evaluated the recurrence of ingrown toenails, regrowth of the nail spike, duration of post-treatment pain and post-treatment infection. RESULTS: Partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of ingrown toenails resulted in a high cure rate, short postoperative pain duration and low risk of postoperative infection. CONCLUSION: This method we advocate is convenient and effective for the treatment of recurrent ingrown great toenail associated with granulation tissue.     

Keloid formation on the great toe after chronic paronychia secondary to ingrown nail

Keloid is a clinically intractable fibro‐proliferative disease that spreads beyond the original scar or lesion. Although several theories have attempted to explain the mechanism of keloid formation, the phenomenon still remains obscure. Our present study examines a rare case of keloid formation that occurred on the great toe after a repeated paronychia secondary to an ingrown nail. The 22‐year‐old female patient had a large keloid with chronic paronychia and a history of ingrown nails on her left great toe on both the lateral nail folds. We excised the keloids and made new lateral nail grooves without extracting the nail. The open wounds were conservatively managed with the help of moisturized dressings until the wounds were completely epithelialised. Adjuvant therapies with oral medication, intermittent intralesional injection and toe care were performed during the follow‐up period. Histopathological analysis of the specimen revealed the presence of irregular, thick, glassy and dense collagen of keloid and inflammation of paronychia. During the 14‐month follow‐up period, adjuvant combination therapies successfully inhibited recurrence of keloid as well as paronychia and the normal appearance of the great toe was maintained. This study addresses a case of keloid formation on the great toe due to repeated recurrence of ingrown nails and consequent chronic paronychia. It is implied that if an ingrown nail is not controlled, it will result in the production of chronic inflammation and tension stress, which might trigger the formation of a secondary keloid.     

A prospective comparison of wedge matrix resection with nail matrix phenolization for the treatment of ingrown toenail

In a prospective study, 110 patients with ingrown toenails were operated on, 55 with wedge matrix resection (WMR) and 55 with nail matrix phenolization (NMP). The patients were randomized on the basis of their address. All patients were reviewed by questionnaire 4 weeks postoperatively to establish the degree of pain, time of pain relief, walking and working ability, and the presence of infection. Furthermore, they were examined clinically at a median follow-up time of 11 months postoperatively to evaluate recurrence rate, rate of spicula formation, and patient satisfaction with regard to cosmesis and symptom relief. The data were tested for statistical significance using the chi-square test and Mann-Whitney rank sum test. The recurrence rate of ingrown toenail for the WMR group was 5.5% (3 patients) with a spicula rate of 36% (20 patients) and a reoperation rate of 20% (9 patients). In the NMP group, there were no recurrences (p = n.s.), the spicula rate was 7.3% (4 patients) (p < .005) and no patients were reoperated on (p < .016). Patient satisfaction with less pain and earlier pain relief was greatest in the NMP group. These results indicate that nail matrix phenolization is an efficient therapy for ingrown toenails and may be preferable to nail wedge resection.     

Surgical options in the management of ingrown toenails in paediatric age group

Background and objectiveThe problem of ingrown toenails is worldwide, affecting all age groups. The aim of this study was to review the different surgical modalities for ingrown toenails in the paediatric age group in a hospital.MethodsWe reviewed case series of 66 children with 89 affected toes, under 16 years of age. The patients were followed up for up to 18 months. The treatment methods practised were: (1) nail avulsion with or without nail matrix ablation using phenol and (2) wedge excision with or without nail matrix ablation using phenol or thermal ablation.ResultsWe found a recurrence rate of 3% for those treated with wedge excision alone compared to 30% when treated with wedge excision and phenol ablation (p = 0.001). Infection rate was also higher for wedge excision with phenol ablation. We achieved cure rate of 97% when using wedge excision alone and 70% when phenol was used for nail matrix ablation.ConclusionWe advocate wedge excision as primary treatment of ingrown toenails in children. We would not recommend phenol ablation of the nail matrix in younger patients as it increases both infection and recurrence rates. The results of nail bed ablation with diathermy appear promising.     

指(趾)甲分型及对甲沟炎的治疗研究

目的 通过对指(趾)甲的分型探索治疗甲沟炎的最佳手术方法。方法 将指(趾)甲分成3个类型，根据不同类型的甲沟炎施以不同的手术。嵌甲型、扁平型采用甲床部分切除，少数病例采用拨甲治疗。凹陷型行甲床部分切除加指(趾)侧梭形切皮整形术，少数病例行甲床部分切除。结果 共治疗437例，治愈410例，复发27例。结论 嵌甲是引起甲沟炎主要的原因。嵌甲型、扁平型甲沟炎采用甲床部分切除根除了嵌甲的情况，疗效甚佳。凹陷型行甲床部分切除加趾侧梭形切皮整形后，甲缘平面被降低，避免了组织受压，治疗后不易复发。     

Zur Behandlung des eingewachsenen Zehennagels

In Germany,"Emmert plasty" is one of the terms most frequently used in daily surgical practice. It describes the wedge excision of nail fold, nail edge, and corresponding matrix for advanced stages of ingrown toenail in most standard textbooks of surgery but without direct reference to Emmert. The method, however,was apparently first described by the French military surgeon Baudens in 1850 and was strongly opposed by Emmert himself who propagated a pure soft tissue resection. This text gives a short historical review of the various treatment methods of ingrown toenails.