Archive for month: August, 2015

FOOT HEALTH REPORT
Presented by Mr Frank Dowling,Podiatrist

Case Study No.2 Ingrowing Toenail

Conor H a 17-year-old West Dublin youth came to my surgery last march complaining of a very painful ingrowing toenail on his big toe of his right foot. When I looked at his nail I could see that the nail was digging in to the skin on the side of his toe, it looked very red and angry
Connor said that his toe began to hurt several months ago after he had worn old football boots which were a little too small for him but as they were his lucky boots and he had a big match coming up he wanted to wear them anyway.

Luckily for him there was no infection present otherwise he might have had to go to his family doctor for a prescription of antibiotics, I explained to Conor that ingrowing toenails can be caused by a number of factors including injury to the toenail, wearing shoes that are too tight around the toe, causing damage to the toenail by constantly picking at the nail (which Conor assured me he never did) the trait for ingrowing toenails can run in families and as it happened both Conors dad and older brother had suffered with that same complaint previously. Years ago when he was a teenager Conors dad had to go to hospital for an operation on his nail.

With conor sitting comfortably I used a weak solution to irrigate the area around his toenail and then gently removed a piece of nail which had grown down the side of his toe before applying a sterile dressing.

Unfortunately, I explained, sometimes the nail has become too far embedded in the side of the toe and although removing part of the nail brings some relief it is only temporary as the nail will continue to grow in.

The treatment of ingrown toenails takes up a large part of a podiatrists time, they are very common, and are usually seen in young people who have a family history of them. Most of the time they can be cured with conservative treatment and advice about wearing correct footwear, I believe that there is no truth in the old wives tale that cutting a “V” in the nail will cure an ingrowing toenail.

A few weeks ago Conor arrived back in the surgery with his toenail as ingrown as ever, he said he had got some relief for a couple of months but it had begun to hurt again and he felt that it was ingrowing as even the pressure of the bedclothes was hurting it,never mind trying to play football .After a brief chat about a more permanent solution to this problem he decided to opt for a partial nail avulsion which is a small surgical procedure performed under local anaesthetic to freeze the toe so a small section of his nail could be removed permanently. This operation is not at all uncomfortable as there is no stitches are suturing involved, a special chemical is applied to the nail bed to prevent the nail from regrowing, it is a very successful procedure with about 95% success rate .The procedure itself takes about one hour in total. Conor played on his DS throughout the procedure and said he did not feel a thing “ it’s over already” said he when I had finished. His dad who came with him for support remarked that it was a different experience from the one he had years ago when he had to go to hospital, have a general anaesthetic and was on crutches for a week after.

When I checked his wound 48 hours later at his redressing appointment everything looked fine and he had no pain or discomfort whatsoever and was looking forward to playing football again in a couple of weeks when the wound healed, needless to say, wearing his new proper fitting football boots. Lucky football boots.