Huang Jia-Zhang, Zhang Yi-Jun, Ma Xin, Wang Xu, Zhang Chao, Chen Li
Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China.
Department of Orthopedics, Huashan Hospital Fudan University, Shanghai, China.
J Foot Ankle Surg. 2015 May-Jun;54(3):395-8. doi: 10.1053/j.jfas.2014.08.022. Epub 2014 Nov 22.
The present retrospective study compared the efficacy of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion for the treatment of ingrown toenails (onychocryptosis). Two surgical methods were performed in 95 patients with a stage 2 or 3 ingrown toenail. Each patient was examined weekly until healing and then at 1, 6, and 12 months of follow-up. The outcomes measured were surgical duration, healing time, recurrence rate, the incidence of postoperative infection, and cosmetic appearance after surgery. Of the 95 patients (115 ingrown toenails) included in the present study, 39 (41.1%) underwent wedge resection (Winograd procedure) and 56 (59%), wedge resection plus complete nail plate avulsion. The mean surgical duration for wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion was 14.9 ± 2.4 minutes and 15.1 ± 3.2 minutes, respectively (p = .73). The corresponding healing times were 2.8 ± 1.2 weeks and 2.7 ± 1.3 weeks (p = .70). Recurrence developed in 3 (3.2%) patients after wedge resection (Winograd procedure) and in 4 (4.2%) after wedge resection plus complete nail plate avulsion. In addition, postoperative infection occurred in 3 (3.2%) patients after wedge resection (Winograd procedure) and 2 (2.1%) after wedge resection plus complete nail plate avulsion. Both of the surgical procedures were practical and appropriate for the treatment of ingrown toenails, being simple and associated with low morbidity and a high success rate. However, cosmetically, wedge resection (Winograd procedure) would be the better choice because the nail plate remains intact.
本回顾性研究比较了楔形切除术（维诺格拉德手术）与楔形切除术加完全拔除趾甲治疗嵌甲（甲下嵌入）的疗效。对95例2期或3期嵌甲患者实施了两种手术方法。每周对每位患者进行检查直至愈合，然后在随访的1个月、6个月和12个月时进行检查。测量的结果包括手术时长、愈合时间、复发率、术后感染发生率以及术后外观。本研究纳入的95例患者（115个嵌甲）中，39例（41.1%）接受了楔形切除术（维诺格拉德手术），56例（59%）接受了楔形切除术加完全拔除趾甲。楔形切除术（维诺格拉德手术）和楔形切除术加完全拔除趾甲的平均手术时长分别为14.9±2.4分钟和15.1±3.2分钟（p = 0.73）。相应的愈合时间分别为2.8±1.2周和2.7±1.3周（p = 0.70）。楔形切除术（维诺格拉德手术）后有3例（3.2%）患者复发，楔形切除术加完全拔除趾甲后有4例（4.2%）患者复发。此外，楔形切除术（维诺格拉德手术）后有3例（3.2%）患者发生术后感染，楔形切除术加完全拔除趾甲后有2例（2.1%）患者发生术后感染。这两种手术方法对于治疗嵌甲都是切实可行且合适的，操作简单，发病率低且成功率高。然而，在外观方面，楔形切除术（维诺格拉德手术）是更好的选择，因为趾甲保持完整。
