TOENAIL SURGERY

Mount Eliza & Mornington Peninsula Area

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Toenail surgery is an effective treatment for various conditions that cause pain, discomfort, or risk of infection, often when non-surgical methods have not been successful.

Here are some of the most common conditions where toenail surgery becomes an option:

 

• Ingrown Toenails (Onychocryptosis): This is the most frequent nail pathology requiring surgery. It occurs when the nail plate punctures the surrounding skin, leading to pain, inflammation, and often secondary infection.

• Traumatic Nail Injuries: Surgery may be needed for nail trauma from an injury.

 

• Fungal Nail Infections (Onychomycosis): In some instances, removing part or all of the nail plate can be beneficial to prepare for effective antifungal treatment.

• Dystrophic Nail Conditions: These involve abnormal growth or shape of the nail plate, causing pain and discomfort.

• Retronychia: This condition involves the backward growth and stacking of nail plates. Treatment typically includes cautious avulsion of the superimposed nail plates and removal of granulation tissue.

• Benign Nail Tumors: The distal digit is susceptible to various benign growths of bone or lesions.

If you find yourself with one of these conditions and need help determining whether nail surgery is an option for you, call us on 03 9708 8626  or book an appointment to see our podiatrist for expert advice and care.

podiatrist performing nail surgery
Will my toenail look normal after surgery?

In many cases, when performed correctly, toenail surgery leads to satisfying functional and aesthetic result. However, there is a possibility of permanent changes such as nail dystrophy or splitting, particularly if the nail matrix is significantly involved or damaged during the procedure to fix the problem. Your podiatrist will discuss the expected cosmetic outcome based on your specific condition and the chosen surgical technique. 

Is toenail surgery painful?

The procedure itself is performed under local anesthesia, so you won’t feel pain during the surgery. The most uncomfortable part is typically the initial needle injection for the anesthetic, but this can be minimised with topical spray. You can expect some postoperative pain, which you can manage with prescribed pain medication from your doctor if necessary.

What's the process for Nail Surgery?
Nail surgery can involve either removing the affected nail or soft tissue using sharp instruments (cold steel procedures) or destroying the problematic tissue through physical means like chemical agents, freezing, or laser.

Before the procedure, your podiatrist will conduct a thorough assessment to ensure surgery is appropriate for you, discussing any medical conditions you may have for consideration.

• Anesthesia: The procedure is performed under local anesthesia to ensure your comfort, which effectively numb the toe. You might feel a brief sting during needle insertion.

• Hemostasis: A tourniquet is typically applied at the base of the digit to create a bloodless field, which is essential for clear visibility during surgery.

• Procedure Steps (often for ingrown nails):

    ◦ Partial Nail Avulsion (PNA): The embedded portion of the nail margin is released, and the nail plate is carefully split and removed longitudinally.

    ◦ Matricectomy: This is the process of destroying or removing a part of the nail matrix (the nail-producing tissue) to prevent regrowth of the problematic nail section. The phenol-alcohol technique is a popular chemical method used for this. Phenol is carefully applied to the exposed nail matrix, often in several 1-minute applications, to achieve permanent destruction.

    ◦ In cases requiring Total Nail Avulsion (TNA), the entire nail plate is removed. Afterward, the nail plate may be trimmed and re-positioned to protect the surgical site and aid drainage.

• Post-operative Care: After surgery, a gauze is applied to the surgical site. You will be advised to keep the operated limb elevated to minimise pain and swelling, and to avoid certain activities for at least two weeks. Routine antibiotics are generally not needed unless there’s an infection.

 

What are the common complications of toenail surgery?

While generally safe, potential complications can include postoperative pain, bleeding, and infection. You might also experience nail dystrophy (changes in nail shape, scarring, splitting, or narrowing of the nail), dysesthesia (altered sensation such as hypersensitivity, increased cold sensitivity, or loss of fine touch), and the formation of nail spicules (small nail spikes). Recurrence of the original problem can also occur.

How long does it take to recover after toenail surgery?

Recovery time varies depending on the specific procedure and individual healing. Generally, defects in the nail bed tend to heal well without permanent scarring. Our podiatrist will advise you to keep the affected limb elevated and avoid strenuous activities, especially for toenails, for at least two weeks. Keeping the wound moist and performing daily soaks can help promote drainage and faster healing.

Step Ahead Podiatric Clinic

If you think that you may have any of these conditions (or another) and want some friendly expert advice and treatment, please feel free to contact us at Step Ahead Podiatry.

Step Ahead Podiatry is located in Mount Eliza, along the Mornington Peninsula of Victoria. 

We are ready to take your enquiries for a consultation on 03 9708 8626 or you can find our contact form at our Contact Us page if you prefer written communication.

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