Clinical Research on Foot & Ankle
Open Access

An ingrown nail, also known as onychocryptosis from Greek ὄνυξ (onyx)'nail'and κρυπτός (kryptos)' hidden', is a common form of nail complaint. It's a frequently painful condition in which the nail grows so that it cuts into one or both sides of the paronychium or nail bed. While ingrown nails can do in the nails of both the hands and the bases, they do most generally with the toenails (as opposed to fingernails), and for the utmost part are only problematic and painful on the big toe [1].

A common generality is that the nail enters into the paronychium, but an "ingrown toe nail" can simply be grown toe skin. The condition starts first from a microbial inflammation of the paronychium, and also a granuloma, which results in a nail buried inside of the granuloma. A true ingrown toenail is caused by factual penetration of meat by a splinter of toenail [2].

Proper cutting leaves the leading edge of the nail free of the flesh, precluding it from growing into the toe. Filing of the corner is reasonable. Some nails require cutting of the corners far back to remove edges that dig into the flesh; this is often done as a partial wedge resection by a podiatrist. Ingrown toe nails can be caused by injury, commonly blunt trauma in which the flesh is pressed against the nail causing a small cut that swells. Injury to the nail can cause it to grow abnormally, making it wider or thicker than normal, or even bulged or crooked.

Ingrown toenails are caused by weight-bearing (activities such as walking, running, etc.) in patients that have too much soft skin tissue on the sides of their nail. Weight bearing causes this excessive amount of skin to bulge up along the sides of the nail. The pressure on the skin around the nail results in the tissue being damaged, resulting in swelling, redness and infection [3]. Many treatments are directed at the nail itself and often include partial or full removal of the healthy nail. However, failure to treat the cutaneous condition can result in a return of the ingrowth and a deformity or mutilation of the nail.

Symptoms of an ingrown nail include pain along the perimeters of the nail (caused by hyper granulation that occurs around the forenamed perimeters), worsening of pain when wearing tight footwear, and perceptivity to pressure of any kind, indeed the weight of bed sheets. Hitting of an affected toe can produce sharp and indeed excruciating pain as the towel is punctured further by the nail [4]. By the veritably nature of the condition, ingrown nails come fluently infected unless special care is taken beforehand to treat the condition by keeping the area clean. Signs of infection include greenishness and lump of the area around the nail, drainage of pus and watery discharge pigmented with blood. The main symptom is swelling at the base of the nail on the ingrowing side (though it may be both sides).

The main contributor to onychocryptosis is footwear, particularly ill-befitting shoes with shy toe box room and tight socks that apply pressure to the top or side of the bottom. Other factors may include the damp atmosphere of enclosed shoes, which soften the nail- plate and beget swelling on the epidermal keratin (ultimately adding the convex bow permanently), genetics, trauma and complaint. Indecorous slice of the nail may beget the nail to cut into the side-fold skin from growth and impact, whether or not the nail is truly "ingrown". The nail bends inwards or overhead depending on the angle of its cut. However, similar as scissors, is at a station in which the lower blade is near to the toe than the upper blade, If the slice tool. The process is visible along the nail as it grows, appearing as a underpinning advancing to the end of the nail. The upper corners turn more fluently than the center of the nail tip. Holding the tool at the same angle for all nails may induce these conditions; as the nail turns near to the skin, it becomes harder to fit the lower blade in the right station under the nail. When cutting a nail, it isn't just the correct angle that's important, but also how short its cut. A shorter cut will bend the nail more, unless the cut is indeed on both top and bottom of the nail [5].

One study compared cases with ingrown toenails to healthy controls and plants no difference in the shape of toenails between those of cases and of the control group. The study suggested that treatment shouldn't be grounded on the correction of a missing nail disfigurement. In some cases, still, there's nail disfigurement [6].

1. Neogi DS, Bandekar SM, Sadekar V, Patnaik S, Bhat T, et al. (2012) Irreducible dislocation of all the lesser metatarsophalangeal joints of the foot: a case report. Foot Ankle Spec 5(5):324-6.

Indexed at, Google Scholar, Crossref

2. Doty JF, Coughlin MJ (2014) Metatarsophalangeal joint instability of the lesser toes and plantar plate deficiency. J Am Acad Orthop Surg 22(4):235-45.

Indexed at, Google Scholar, Crossref

3. Maas NM, Van Der Grinten M, Bramer WM, Kleinrensink GJ (2016) Metatarsophalangeal joint stability: a systematic review on the plantar plate of the lesser toes. J Foot Ankle Res 9(1):1-0.

Indexed at, Google Scholar, Crossref

4. Johnston RB, Smith J, Daniels T (1994) The plantar plate of the lesser toes: an anatomical study in human cadavers. Foot Ankle Int 15(5):276-82.

Indexed at, Google Scholar, Crossref

5. Richter M, Wippermann B, Krettek C, Schratt HE, Hufner T, et al. (2001) Fractures and fracture dislocations of the midfoot: occurrence, causes and long-term results. Foot Ankle Int 22: 392-398.

Indexed at, Google Scholar, Crossref

6. Mar GJ, Barrington MJ, McGuirk BR (2009) Acute compartment syndrome of the lower limb and the effect of postoperative analgesia on diagnosis. Br J Anaesth 102: 3-11.

Indexed at, Google Scholar, Crossref