Ingrown toe-nail: A clinical study

Carl J. Heifetz

doi:10.1016/S0002-9610(37)90439-2

Original article| Volume 38, ISSUE 2, P298-315, November 1937

Ingrown toe-nail

A clinical study

Carl J. Heifetz, M.D.
Carl J. Heifetz
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Jewish Hospital of St. Louis. St. Louis, Missouri, USA
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1 From the Surgical Service of the Aaron Waldheim Health Clinic, Jewish Hospital of St. Louis.

DOI:https://doi.org/10.1016/S0002-9610(37)90439-2

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Abstract

Extensive review of the literature and considerable clinical experience with the handling of ingrown toe-nails have prompted the writer to summarize the present status of the subject, and to outline a simplified mode of management that will be applicable to any stage of the lesion, and that will incur a minimum loss of time to the patient.

The symptoms and signs of ingrown toe-nail are conveniently divided into three stages: (1) inflammatory swelling and redness, (2) inflammatory secretion, (3) granulation tissue formation.

The numerous methods of treatment encountered in the literature can only lead to confusion to the average practitioner of minor surgery. The writer has attempted to facilitate treatment by advocating a simplified mode of management, consisting of a conservative method for handling early cases and cases not amenable to operative procedures, and a radical method for handling the more advanced cases. Both types of treatment allow the patient to be ambulatory.

The use of cotton packing, if properly applied, is one of the simplest and most effective means of conservative treatment, and is recommended for most cases in the first stage and some in the second stage of the lesion.

Radical operation is greatly simplified in the method of Winograd, which the writer uses with a few modifications in all cases in the third stage and most cases in the second stage of the lesion.

With a knowledge of the main etiological factors, a recognition of the three stages of the lesion, and a thorough acquaintance with these two procedures, it is possible to manage intelligently and adequately the vast majority of the cases of ingrown toe-nail with assurance that the results will be satisfactory and that the incapacitation will not be out of proportion to the apparent severity of the lesion.

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DOI: https://doi.org/10.1016/S0002-9610(37)90439-2

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