Nail surgery

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Nail surgery is a common procedure performed by most podiatrists to effectively treat an ingrown toenail, a nail that has pierced (or is pressing against) the adjacent skin of the toe causing pain and inflammation and sometimes infection.

Surgery may be required when an ingrown toenail repeatedly gets infected, is continually painful, when the patient is unable to wear shoes or the condition inhibits work, sporting or other activities.

Before surgery is recommended, your podiatrist will explore other, more conservative treatment options.

Nail surgery performed by Podiatrists

A ‘Partial Nail Avulsion’ (known as a PNA or nail root and matrix resection) is a minor nail procedure which aims to permanently treat ingrown toenails. The procedure is usually performed in the podiatrists’ rooms, takes around one hour and the patient is able to walk immediately afterwards.

What does a partial nail avulsion involve?

Your podiatrist will conduct a complete assessment, taking a medical history, a list of any medications that have been prescribed for you, as well as considering any other clinical factors that will determine whether or not this surgery is suited to you. An assessment will generally also include an examination of blood supply to the foot.

The procedure itself is performed under local anaesthetic via injection into the toe to numb the area. The anaesthetic will wear off in about two hours. Once numb, a tight elastic ring called a tourniquet is applied to the toe to control bleeding and the area is prepped to minimise the risk of infection.

The offending portion of the nail is then gently lifted and trimmed away, generally without the toe being cut or stitched. Both sides or the entire nail may be removed this way. A chemical may also be used, at this point, to assist in preventing nail regrowth.

Once the procedure is completed, the tourniquet is removed and a sterile dressing is applied. The patient is able to walk immediately afterwards, however, assistance getting home is strongly recommended.

What happens after the procedure?

Re-dressing at home and review consultations with your podiatrist may be required over the following two to three weeks following the procedure. For the first few days after the procedure, pain relief, the use of open toed shoes and activity modification may be necessary, however, interference with day to day activities is generally minimal.

What are the potential complications?

As with any surgical procedure there is some risk of complication, however, this procedure is known to be very safe and effective.
The most common side-effects are post-operative infection, in the short term, and the possibility of regrowth of the nail over time. The risks of infection can be minimised through good post-operative care and your podiatrist will advise and assist with your situation.

WARNING: This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.