Ingrown toenail or overgrown toe skin?: Alternative treatment for onychocryptosis.

There are currently many surgical options for treating the “ingrowing toenail” (for example, wedge resection, which is demonstrated in this month’s Video Series); however, they tend to have high rates of recurrence, poor cosmetic results, and low rates of patient satisfaction.1 According to a 2005 Cochrane Review, rates of regrowth after the long-standing treatment (phenolization) were 34% for GPs and 50% for general surgeons.1 In 1959, Vandenbos and Bowers noted that patients who developed this problem tended to have an excessive amount of tissue at the sides of the affected nail. They theorized that weight-bearing caused the tissue to bulge over the sides of the nail, resulting in pressure necrosis.2 The Vandenbos procedure (described below) took form based on this theory and now challenges the current paradigm.