Partial Nail Avulsion Procedure for Ingrown Toenails

What is an ingrown toenail?

Ingrown  toenails can  be  debilitating,  footwear  dictating and just downright painful. They occur when the nail edge pushes into and/or irritates the nail sulci,  commonly  resulting  in  infection and  inflammation. It can also occur when a nail 'spike' is left behind from cutting the nail incorrectly. For most suffers this occurrence is all too familiar and dreaded, and  can  interrupt  sporting  activities  and  limit shoe selection.


Do all ingrown toenails require a Partial Nail Avulsion

First  time  cases  can  usually  be  managed  conservatively,  depending  on  the  severity. This involves seeing your Podiatrist for reduction of the nail edge, removal of any nail spike, callous and debris that may be present. If swollen, red tissue (also known  as hyper  granulation  tissue)  is  present  on  the  nail  fold  or  growing  over the  edge of the nail, your Podiatrist may be able to reduce this conservatively. Warm salt baths  for  the toe, application  of  an  antiseptic and  a  bandage  are  recommended to  ensure the area is kept clean. In more severe cases, antibiotics may be required. Your Podiatrist can help determine this and provide you a referral to see the doctor.

For  those with  long-­‐standing  discomfort  and  repeated  episodes  of  inflammation/infection, the best treatment is to undergo a Partial Nail Avulsion (PNA),  also  known  as  a  nail  wedge  resection. It  is  a  more  permanent  treatment  modality and saves you having to visit your Podiatrist every few months!

What does the procedure involve?

We book a 1 hour appointment for the procedure, but it generally takes less time than this. The procedure involves:

  • A  local  anaesthetic  injection  to  numb  the  affected  toe and  waiting  for  10 minutes to ensure the toe is numb

  • Using a sterile technique and instruments, the nail edge is removed and sulci is cleared

  • Application of a chemical called Phenol, that prevents re-­growth of the nail

  • A  follow  up  appointment with  the  Podiatrist  is  booked  within  3 -­ 6  days  to change the dressing and ensure healing has started.

What is the recovery time following a Partial Nail Avulsion?

Recovery from a PNA is relatively quick, but depends on your overall foot health. We recommend  taking  1 - 2  days  to  rest  and  elevate  your  feet  and  wearing  open-toed  footwear. Most athletes and even kids are able to return to play within a couple of days. The aim for the next few weeks is to heal the nail bed, which usually takes 2 - 4 weeks  in  total.  Your  Podiatrist  will  provide  you  with  a  dressing  plan  that  can  be  followed at home.

If  you  have  any  further  questions,  please  contact  our  Podiatrists  on  9598  8221.