Lateral fold rotational flap technique for treatment of ingrown nail.

An ingrown nail is a common disorder that occurs most frequently in the great toe and causes much discomfort in patients. Although many therapeutic methods have been described, most of them can lead to severe damage to the nail, poor cosmetic appearance, or frequent relapses. The treatment of choice for an ingrown toenail has been surgical rather than non-surgical. However, available surgical treatment modalities fail to achieve good esthetic results with low recurrence rates, leaving the toe with a difficult to treat deformity. Our objective in this study is to present a new surgical approach to ingrown toenail treatment based on flap technique to improve the esthetic and functional outcome with low recurrence rate. Twenty patients with 25 affected toes and 34 ingrown toenail margins were operated upon with partial matricectomy followed by lateral fold rotational flap coverage. The patients returned to their normal activity within one week (mean 3.65 ± 1.6 days). The follow up period ranged from 6-12 months (mean 7.8 ± 1.9 months). We had one recurrence in the form of spicule formation in the lateral fold (2.94%). The cosmetic evaluation revealed satisfied patients in 4 cases (20%) and 16 patient evaluated their results as good (80%). In conclusion we believe that the lateral fold rotational flap is a reliable, selective, and esthetically pleasing technique for treatment of all stages of ingrown toenail.