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。     

部分甲母质切除甲沟成形术治疗重症嵌甲症

目的对156例重症复发性甲沟炎病例,采用部分甲母质切除甲沟成形手术治疗,观察远期疗效。方法对选择的病例先控制炎症再行手术,手术按设计要求进行。结果平均经过8个月临床随访,2例复发,经再次手术治愈;4例患处见鱼刺状残甲长出(部分复发),经予剔除,同时处理甲母质残余物后愈,满意率96%。结论手术按严格设计要求进行是治疗并预防手术后复发的关键。     

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。     

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。     

甲板及甲基质部分切除联合拇趾腹重建甲沟治疗嵌甲性甲沟炎

目的探讨甲板及甲基质部分切除联合拇趾腹重建甲沟治疗嵌甲性甲沟炎的临床疗效。方法对76例嵌甲性甲沟炎患者采用甲板及甲基质部分切除联合拇趾腹重建甲沟术治疗,评价治疗效果。结果 76例均获随访,时间8~12个月。2例复发残甲,总有效率达97.4%。结论采用甲板及甲基质部分切除联合拇趾腹重建甲沟术治疗嵌甲性甲沟炎操作简便,对趾甲损伤小,患者痛苦轻,并发症少,治愈率高。     

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。     

部分甲体甲床甲母质切除甲沟成形术治疗嵌甲型甲沟炎256例

目的:探讨一种利用甲侧襞皮瓣改变甲体与甲沟的位置结构,从而彻底治愈嵌甲型甲沟炎的手术方法。方法:切除部分甲体、甲床及甲母质,并利用甲侧襞皮瓣成形甲床、甲沟、甲侧襞联合结构。结果:本院2010年1月～2011年6月对256例嵌甲患者,足趾255例、手指1例,共376侧嵌甲进行甲沟成形手术,随访6月～2年,取得满意效果。结论:本手术从根本上彻底解决了嵌甲的病因,手术并发症少,复发率极低。     

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。     

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。     

改良Winograd术联合甲沟重建术治疗重度嵌甲症的疗效

目的 回顾性分析改良Winograd术联合甲沟重建术治疗重度嵌甲症的临床疗效。方法 2015年8月-2022年8月,对53例63趾重度嵌甲症采用切除1/4～1/5甲床及甲根部的甲母质,清除肉芽肿及坏死糜烂,切除少部分甲皱襞,使用垂直褥式内翻缝合法重建甲沟。结果 术后2例出现红肿、渗出,给予拆线、换药、使用敏感抗生素后炎症消退,切口愈合;其他均一期愈合。术后2～3周拆除缝线。48例术后得到3～24个月,平均13个月随访,5例失访。所有随访患者均无嵌甲复发,无疼痛,不影响步态。外观良好,新生甲板无明显缩窄、畸形,患者满意度较高。结论 改良Winograd术联合甲沟重建术治疗重度嵌甲症可取得满意的临床疗效。     

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.     

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.     

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。     

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??Deck orthopedic surgery in the treatment of cure obstinate ingrown nail: an analysis of 25 cases XIA Yue-shan*??ZHAO Hai-yong??MA Na .* Railway Central Hospital of Tangshan , Tangshan 063000??China
Corresponding author??ZHAO Hai-yong??E-mail??mana77@163.com
Abstract Objective To adopt a method for curing the obstinate ingrown nail by transplanting a soft tissue flap with a pedicel under the edge of the toenail in deck orthopedic surgery.??Methods The clinical data of deck orthopedic surgery to cure obstinate ingrown nail performed between February 2001 and June 2009 at Railway Central Hospital of Tangshan were analyzed. Remove prismatical skin at the edge of the toenail, design a soft tissue flap with a pedicel, strip off the edge of the toenail bed from the toebone, transplant a soft tissue flap with a pedicel under the edge of the toenail to alter the ingrowing toenai bed and deck deformity.??Results All cases of obstinate ingrown nail after the operation had recovered with satisfied results under 6 months to 1 years follow-up.??Conclusion The operation gets rid off the causes of obstinate ingrown first toenail, has few complications and few recurrences.     

A Simple, Pain-Free Treatment for Ingrown Toenails Complicated with Granulation Tissue

BACKGROUND: The treatment of ingrown toenail complicated with granulation tissue is usually partial or total nail avulsion with or without matricectomy. It costs loss of occupational power, however, because most patients cannot go to work or school for some time after surgery, and it is a costly and uncomfortable procedure for most patients. OBJECTIVE: This study aimed to find an easy, painless, and inexpensive alternative. MATERIALS AND METHODS: Seven patients with ingrown toenails complicated with granulation tissue are included. A small apparatus was applied on the nails, granulation tissue was chemically cauterized, and a foot bath was recommended twice daily. They were followed on a weekly basis or every other week until recovery. None of the patients received systemic treatment. RESULTS: All seven patients were completely cured without requiring surgery and/or systemic treatment. The procedure did not have any effect on their daily life. The follow-up examination of the patients at 6 months revealed that they were totally cured, and there were no recurrences. CONCLUSION: Patients with ingrown toenails complicated by granulation tissue might have an inexpensive and pain-free treatment alternative, although new studies with more patients are required.     

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.     

Wedge excision of the nail fold in the treatment of ingrown toenail

Many treatment modalities of ingrown toenail are reported in the literature, often associated with unacceptably high recurrence rate. The authors present their technique, which aims at reducing the convexity of the nail fold. After complete removal of the nail plate and accurate debridement of the granulomatous tissue, a wedge-shaped ellipsis of skin and subcutaneous tissue, lateral to the affected nail fold, is removed. Approximation of the margins of the resulting defect determines eversion of the nail fold. One hundred twenty ingrown toenails were treated with the wedge excision of the nail fold at the outpatient clinic of the department of plastic surgery, Campus Bio-Medico University, Rome, Italy, between January 1998 and January 2002. Six recurrences were observed. In addition to the high cure rate, short postoperative pain duration, and morbidity as well as low risk of postoperative infection, the remarkable esthetic results achievable with this method are indicated.