Wedge Resection and Nail Groove Reconstruction With Hanging Thread Knot in the Treatment of Onychocryptosis.

Abstract

Background: Onychocryptosis is characterized by the nail plate penetrating the lateral nail fold, resulting in varying degrees of infection and deformity. Standardized treatment protocols for onychocryptosis, particularly in Stages IIb, III, and IV, have not been universally established, highlighting the urgent need for the development of effective interventions.

Objective: To evaluate the effectiveness and safety of wedge resection and nail groove reconstruction using the hanging thread knot for the treatment of onychocryptosis.

Methods: At our hospital, a total of 155 patients with onychocryptosis in Stages IIb, III, and IV underwent treatment. Wedge resection and nail groove reconstruction with the hanging thread knot were applied based on the severity of deformity and infection for treating onychocryptosis. All patients received perioperative systematic and topical anti-infective treatments. Follow-ups conducted over a period of 2-6 months assessed postoperative rehabilitation and complications.

Results: The cure rate reached 95%, with a low recurrence rate of 5%. Recurrence, observed in eight patients, was attributed to various causes: three due to improper trimming, three related to trauma, one associated with obesity, and one due to incomplete matrix resection. All eight patients achieved complete recovery through health guidance and secondary surgery. Satisfaction results were reported during the 2-6 months follow-up period. Although 10 patients experienced secondary local infections, all achieved complete recovery following active treatment.

Conclusion: Wedge resection and nail groove reconstruction with the hanging thread knot prove to be an effective and safe method for treating onychocryptosis.