儿童和青少年的嵌甲：拔甲是否优于非手术治疗？
Ingrowing toenails in children and adolescents: is nail avulsion superior to nonoperative treatment?
机构信息
Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore.
出版信息
Singapore Med J. 2019 Feb;60(2):94-96. doi: 10.11622/smedj.2018106.
INTRODUCTION
Ingrowing toenail (IGTN) or onychocryptosis is not uncommon in children and adolescents. However, there is a dearth of evidence in the literature on the management of IGTN in this age group. This study aimed to compare the results of nonoperative treatment for IGTN with that of operative treatment among children and adolescents.
METHODS
All children and adolescents who were treated for IGTN at our institution between 2010 and 2014 were included for this retrospective study. Demographic data, treatment prescribed and outcome at six months after presentation were analysed.
RESULTS
Overall, 199 patients were recruited. There were 123 (61.8%) boys and 76 (38.2%) girls. Median age was 14 years. Among 199 toes, 162 (81.4%) were treated nonoperatively, with nail care advice, topical antibiotics and daily cleansing. Only 37 (18.6%) toes were treated operatively. In the operative group, 23 (62.2%) patients underwent wedge resections, while the remaining 14 (37.8%) had total nail avulsions; for all patients, germinal matrices were preserved. At the six-month follow-up, there were 5 (3.1%) cases of recurrence in the nonoperative group when compared to 3 (8.1%) recurrences in the operative group.
CONCLUSION
We recommend that IGTN in children and adolescents be treated in the first instance by nonoperative methods. Operative options can be considered for resistant cases or in case of recurrence of IGTN.
简介
嵌甲（IGTN）或甲下内翻并不少见，尤其在儿童和青少年中。然而，关于这一年龄组IGTN 的管理，文献中证据匮乏。本研究旨在比较非手术治疗与手术治疗儿童和青少年 IGTN 的结果。
方法
本回顾性研究纳入了 2010 年至 2014 年期间在我院接受 IGTN 治疗的所有儿童和青少年。分析了人口统计学数据、所开处方的治疗方法和就诊后 6 个月的结果。
结果
共有 199 例患者被纳入研究。其中 123 例（61.8%）为男孩，76 例（38.2%）为女孩。中位年龄为 14 岁。在 199 个脚趾中，162 个（81.4%）采用非手术治疗，即给予指甲护理建议、局部使用抗生素和每日清洁。只有 37 个（18.6%）脚趾接受了手术治疗。在手术组中，23 例（62.2%）患者接受了楔形切除术，而其余 14 例（37.8%）患者则接受了全甲撕脱术；所有患者的生发基质均得以保留。在 6 个月的随访中，非手术组中有 5 例（3.1%）复发，而手术组中有 3 例（8.1%）复发。
结论
我们建议儿童和青少年的 IGTN 首先采用非手术方法治疗。对于顽固病例或 IGTN 复发的情况，可以考虑手术治疗。
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