A Case of Ingrown Toenail: Mr. Saradhi’s Journey to Recovery
Mr. Saradhi, a 45-year-old businessman with an active lifestyle, presented with swelling and pain in his left great toe. Upon examination, it was clear that the corner of his toenail had started growing into the flesh, causing significant discomfort for the past two months.
Patient Background
Saradhi has a family history of similar issues—his father experienced the same problem. Being a businessman in a foreign country, he often travels and attends numerous meetings. His discomfort had grown to the extent that he carried his shoes in the car, wearing them only for meetings and promptly removing them afterward. In an effort to alleviate the problem, he switched to wide toe box shoes, as his feet are slightly wider than average. Fortunately, Saradhi is not diabetic and maintains exemplary health habits, with an HbA1c of 5—well within normal limits.
Clinical Findings
On close examination, his toe was swollen, beads of pus noted and the toenail had a curved profile from side to side. The inner corner of the nail was digging into the flesh, resulting in unhealthy granulation tissue at the site of penetration. Interestingly, the granulation tissue had begun to epithelialize, giving it the appearance of new skin formation.
Treatment Procedure
Under a toe block (local anesthesia), total nail was carefully removed, and the excess granulation tissue was excised with a surgical scoop. The area was thoroughly cleaned, and dressings were applied.
Post-Procedure Care and Advice
The dressings need to be maintained for about a week, during which the nail is expected to grow back. Saradhi was advised to let the nail grow slightly beyond the tip of the toe and avoid trimming it too short, as this could encourage the nail to grow into the flesh again.
If the nail shows signs of regrowing into the flesh or does not grow correctly, surgical techniques may be considered to modify the nail bed. This may involve flattening the nail bed and slightly increasing its width to prevent recurrence.
Key Takeaway
Ingrown toenails, while common, can severely impact quality of life if left untreated. Early intervention, proper footwear, and regular follow-up are essential for successful recovery and prevention of recurrence.
