The management of ingrowing toenails

#### Summary points #### Sources and selection criteria We searched Medline (PubMed), the Cochrane Database of Systematic Reviews , Cochrane central register of controlled trials, and CINAHL using the search terms “ingrowing toenails”, “ingrown toenails”, and “onychocryptosis”. We identified additional literature from the references of identified papers. In addition, we consulted standard orthopaedic textbooks on the subject and reviewed the main references quoted. Ingrowing toenails are a common condition that causes pain and disability in the foot. The condition occurs when the nail plate traumatises the nail fold, giving rise to pain, inflammation, or infection (or a combination thereof). It commonly occurs in the great toe but can also affect the lesser toes. Patients with ingrowing toenails are usually male, between the ages of 15 and 40 years; they are often encountered in general practice, with an estimated 10 000 new cases presenting in the United Kingdom each year.1 The condition is managed by a wide variety of healthcare professionals including general practitioners, podiatrists, dermatologists, general surgeons, and orthopaedic surgeons. The surgical treatments for ingrowing toenails include procedures on the nail plate, the nail bed (germinal matrix), and the surrounding soft tissues. Historically, a recurrence rate of 13-50% has been reported after surgical treatment,2 although more recent papers have reported recurrence rates of less than 5%, particularly with the use of wedge resection of the nail and phenol ablation …