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Dr. Brandon Macy
Podiatrist - Clark, NJ
1114 Raritan Road
Clark, NJ 07066




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Posts for tag: nail surgery

By Brandon Macy, D.P.M.
March 15, 2011
Category: Toenail problems

Ingrown nails are about the most painful, annoying problems I encounter on a daily basis. Aside from the pain there's also the risk of infection which can be an even more serious problem if you're diabetic or have P.A.D. (poor circulation).


Exactly what are ingrown toenails? What causes them? How are they treated?


The real issue here is the shape of the nail plate. Normally, the nail is relatively flat with only a slight curvature. Due to hereditary factors, shoe pressures, and deformities such as bunions which can cause the big toe to squeeze onto the 2nd toe, the curvature of the nail plate can increase. The sides of the nails can make a deep groove. As the nail grows towards the tip of the toe, the edge of the nail can't grow past/over the skin at the end of the groove and begins to poke you.


If you're lucky, this causes only minor discomfort or inflammation which can be relieved by rounding the corner of the nail slightly. If there's an irregularity of the nail plate or in a botched attemd to round the corner, a spike, or spicule, of nail can be left behind in the nail groove. This can act like a knife, causing even greater pain with the possibility of it penetrating the skin, resulting in an infection.


Whn infected, there may be an abscess, or a more gross infection with oozing and drainage. Occasionally, a small lump of pink tissue, often called "proud flesh" or a pyogenic granuloma that bleeds easily when manipulated can form when the process has been going on for a while. Clearly, this needs prompt professional attention as this condition will not go away on its own.


At this point, we typically remove the side of the nail under local anesthesia, usually done in the office in just a few minutes' time. Relief is pretty much immediate and recovery is very quick with virtually no disability. Oral antibiotics are given only in the most severe cases and antibiotics alone without dealing with the nail itself will not resolve the problem.


For chronic, repetitive problems with ingrown nails, we recommend a procedure called a matrixectomy. Also perfomed in the office under local anesthesia, the offending nail border (usually NOT the entire nail) is removed and the matrix of the nail, comonly referred to as the "root" of the nail is chemically cauterized. This procedure is designed to permanently remove the side of the nail that is causing the problems. Healing time from this is a bit longer than following treatment for a simple infection, but disability remains minimal.


A few self-care tips:


When trimming nails, for the most part you do want to cut them straight across. There is, however, nothing wrong with SLIGHTLY rounding the corners so there are no sharp points. The nail is rectangular, the tip of the toe round--fitting square pegs into round holes can cause trouble.


There persists an old wives' tale that cutting a V-shaped notch in the tip of the nail can cause the nail to somehow grow away from the sides. This is absolutely not true. The nail plate is not under any tension and even if it were, the nail would need to unfold, not grow away from the sides--wrong plane.


Stuffing cotton under the nail border does not make for guiding the nail to grow up and over the skin.


Most importantly, if you are in pain, if there's redness of the nail groove, or if there's an abscess or drainage, contact uIschemic Foots at once to make an appointment to have the problem corrected. You'll feel a lot better--and quickly!



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1114 Raritan Road
Clark, NJ 07066

Podiatrist - Clark, Dr. Brandon Macy, 1114 Raritan Road, Clark NJ, 07066 732-382-3470