部分拔甲治疗嵌甲效果观察

目的观察部分拔甲术治疗嵌甲的临床效果。方法将100例嵌甲拟行拔甲治疗的患者随机分为观察组和对照组各50例，对照组采用全甲拔除术，观察组行部分拔甲术。结果两组治疗效果比较，差异无显著性意义（P〉0．05）；两组拔甲和首次换药剧痛率比较，差异有显著性意义（P〈0．01）。结论部分拔甲术治疗嵌甲疗效好，同时可减轻患者痛苦，促进创面愈合。     

部分拔甲、甲沟重建术治疗98例拇趾嵌甲症的效果分析及护理体会

目的:探讨部分拔甲、甲沟重建术治疗拇趾嵌甲症的疗效及护理.方法:将我院2008年1月-2010年12月门诊98例拇趾嵌甲症患者实施部分拔甲、甲沟重建术.结果:98例拇趾嵌甲症患者10-12天甲床干燥无渗出,1-2个月左右旧趾甲退尽,长出正常新趾甲,经12个月随访仅2人复发.结论:部分拔甲、甲沟重建术治疗拇趾嵌甲症因创面小,有效缩短病人换药时间,使复发率大大降低,约为2%,是一种良好的治疗拇趾嵌甲症的方法.并且专业的护理、换药技术减轻了患者的痛苦,提高了病人的满意度.     

改良部分拔甲术治疗顽固性甲沟炎

甲沟炎是指(趾)甲周围组织的化脓性炎症，常因工作或劳动中不慎被异物刺伤，或撕拔指(趾)甲旁倒刺而引起。起病时，患指(趾)一侧出现红肿、疼痛，随病情加重局部肿胀明显、张力增高，皮肤苍白，有跳痛，肢体下垂时疼痛加重，夜间常因疼痛不能入睡，并有发热等全身症状。顽固性甲沟炎表现为反复发作的甲沟炎症状，指(趾)端红、肿、疼痛，患指(趾)一侧的组织肿胀、甲床变形、甚至甲床下积脓，以拇趾最为常见。病人有多次因甲下积脓行“拔甲术”病史。     

综合方法治疗非霉菌性嵌甲症的疗效评价

目的:探讨综合方法治疗非霉菌性嵌甲症的临床效果评价.方法:2007-2009年患者142例随机分为综合方法组(60例),其中学生42例及对照组(60例),其中学生45例,两组患者分别于综合方法组予以综合方法治疗及对照组予以按诊疗常规予以行单纯拔甲术治疗.结果:综合方法组显效率和无效率为93.3%、6.7%及11.7%、88.3%(对照组),差异有显著意义.结论:综合方法治疗非霉菌性嵌甲症疗效优于常规予以行拔甲术治疗.     

重度拇嵌甲症192例的外科治疗观察

目的:提高拇嵌甲症的临床治愈率。方法:分析了192例重度拇嵌甲症发生的原因。在单纯拔甲术的基础上,行拇趾患侧的甲床、软组织及相应的甲根部、甲床纵行切除术。根据病情补加趾患侧甲沟前侧缘新月形皮肤皮下软组织切除术。结果:192例重度拇嵌甲症,随访185例,手术治愈180例,延迟愈合5例。结论:该手术治疗方法矫正了重度拇嵌甲症的解剖病变,明显提高了临床治愈率。     

踇趾部分甲皱襞和甲床楔形切除治疗嵌甲

嵌甲是对趾甲护理不当引起的钩状生长，趾甲向深部，长入叠盖的甲皱襞，嵌入甲沟内，使两侧甲沟消失。嵌甲多见于四趾，目前临床上对嵌甲Ⅰ期（炎症期）和Ⅱ期（脓肿期）的早期采取保守治疗；而对于Ⅱ期的晚期和Ⅲ期采取手术治疗，但术后复发率较高。为降低复发率，我们在1998年6月～2004年9月，采用楔形切除部分甲皱襞和甲床治疗嵌甲，疗效满意。报告如下。     

拔甲术后局部创面照射治疗效果观察

目的 观察拔甲术后采用电磁波照射促进患者伤口愈合的作用.方法 将137例(148趾)患者随机分为观察组(69例75趾)和对照组(68例73趾).观察组拔甲后第1次换药时对创面进行照射,再用活力碘纱布包扎.对照组拔甲后创面采用抗生素纱条换药,直至伤口愈合.结果 观察组治愈时间、换药次数、疼痛减轻程度显著优于对照组(均P<0.01).结论 拔甲术后采用电磁波照射能促进患者伤口愈合、减轻疼痛,且安全易操作.     

部分甲母质切除甲沟成形术治疗重症嵌甲症

目的对156例重症复发性甲沟炎病例,采用部分甲母质切除甲沟成形手术治疗,观察远期疗效。方法对选择的病例先控制炎症再行手术,手术按设计要求进行。结果平均经过8个月临床随访,2例复发,经再次手术治愈;4例患处见鱼刺状残甲长出(部分复发),经予剔除,同时处理甲母质残余物后愈,满意率96%。结论手术按严格设计要求进行是治疗并预防手术后复发的关键。     

趾部分甲皱襞和甲床楔形切除治疗嵌甲

嵌甲是对趾甲护理不当引起的钩状生长,趾甲向深部,长入叠盖的甲皱襞,嵌入甲沟内,使两侧甲沟消失。嵌甲多见于趾,目前临床上对嵌甲期(炎症期)和期(脓肿期)的早期采取保守治疗;而对于期的晚期和期采取手术治疗,但术后复发率较高。为降低复发率,我们在1998年6月~2004年9月,采用楔形切除部分甲皱襞和甲床治疗嵌甲,疗效满意。报告如下。1临床资料1.1一般资料本组139例(164侧)。男117例(140侧),女22例(24侧)。年龄12~28岁,平均17.3岁。病程2个月~6年。期主要表现为局部红肿、多汗及疼痛剧烈,两侧甲皱襞肿胀高出甲板侧缘,有渗出;期主要表现为甲板…     

嵌甲性甲沟炎的治疗

甲沟炎一般是因甲廓部的倒刺、甲廓损伤或慢性刺激导致细菌侵入皮下引起,也可由指（趾）甲长入甲沟内引起,前者可经过清创、换药、切开引流等措施治疗,对于后者引起的甲沟炎,传统的治疗方法往往是拔甲,而拔甲术后效果持续时间较短,待到新趾甲长出又会引起甲沟炎,需再次行拔甲术,临床上经常看到反复拔甲1～4次仍未痊愈的患者。笔者近3年来对嵌甲性甲沟炎患者采取切除嵌甲侧少部分趾甲、甲床及部分侧甲廓、对应的少部分甲母、甲沟内炎性组织,术后取得良好的治疗效果,笔者称其为嵌甲整形术,可一次性治愈嵌甲性甲沟炎。     

Treatment of Recurrent Ingrown Great Toenail Associated with Granulation Tissue by Partial Nail Avulsion Followed by Matricectomy with Sharpulse Carbon Dioxide Laser

BACKGROUND: The effectiveness of partial nail avulsion followed by matricectomy with carbon dioxide (CO2) laser for the treatment of ingrown great toenails remains unclear. OBJECTIVE: This study sought to determine the effectiveness of partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of recurrent ingrown great toenails associated with granulation tissue. MATERIALS AND METHODS: Fourteen patients with a total of 18 recurrent ingrown great toenails were randomly selected for participation in this study. Partial nail avulsions followed by matricectomy with sharpulse CO2 laser were performed on the involved nails. After at least 6 months, we evaluated the recurrence of ingrown toenails, regrowth of the nail spike, duration of post-treatment pain and post-treatment infection. RESULTS: Partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of ingrown toenails resulted in a high cure rate, short postoperative pain duration and low risk of postoperative infection. CONCLUSION: This method we advocate is convenient and effective for the treatment of recurrent ingrown great toenail associated with granulation tissue.     

Partial Matricectomy with a CO2 Laser for Ingrown Toenail after Nail Matrix Staining

BACKGROUND: Ingrown toenail is a common nail disease that causes pain, discomfort, and difficulty in walking. It is treated with either conservative therapy or surgery. OBJECTIVE: To present a new surgical approach to ingrown toenail. MATERIALS AND METHODS: For 19 ingrown toenail borders of 14 toes in 14 patients (1 male and 13 females), the nail matrix was stained with methylene blue and then partial matricectomy was performed with a CO2 laser. RESULTS: There was no recurrence at 18 nail borders after a mean follow-up period of 13.4 months, whereas a spike grew at one border but caused no walking pain. No serious complications occurred. Cosmetic improvement was also satisfactory. CONCLUSIONS: Partial nail matricectomy with a CO2 laser after staining the nail matrix with methylene blue allows visual confirmation of the completeness of cauterization.     

A Surgical Approach to Ingrown Nail: Partial Matricectomy Using CO2 Laser

BACKGROUND: Ingrown nail is a deformity characterized by a transverse overcurvature of the lateral nail plate that causes nail fold inflammation. Currently recommended surgical procedures vary considerably. OBJECTIVE: We report our experience with a modified partial matricectomy and nail edge excision with CO2 laser. METHODS: A total of 116 ingrown nail edges in 77 patients were treated with the procedure. RESULTS: The incidence of recurrence was 2 of 76 cases (2.6%). CONCLUSION: This new surgical approach was found to be effective and is presented as an alternative treatment technique.     

部分甲体甲床甲母质切除甲沟成形术治疗嵌甲型甲沟炎256例

目的:探讨一种利用甲侧襞皮瓣改变甲体与甲沟的位置结构,从而彻底治愈嵌甲型甲沟炎的手术方法。方法:切除部分甲体、甲床及甲母质,并利用甲侧襞皮瓣成形甲床、甲沟、甲侧襞联合结构。结果:本院2010年1月～2011年6月对256例嵌甲患者,足趾255例、手指1例,共376侧嵌甲进行甲沟成形手术,随访6月～2年,取得满意效果。结论:本手术从根本上彻底解决了嵌甲的病因,手术并发症少,复发率极低。     

Long-Term Results of Nail Brace Application in Diabetic Patients with Ingrown Nails

BACKGROUND Ingrown toe nail is a common foot problem; however, there are limited data concerning the treatment options for diabetic patients.
OBJECTIVE Because of the special attention given to avoidance of infection and ulceration of the foot in diabetics, we applied a new, simple nail device as a treatment option without any systemic treatment or surgical intervention.
METHODS AND MATERIALS We applied braces to 21 diabetic patients with ingrown toe nails. All had severe pain, erythema, and edema without suppuration or granulation tissue formation. Braces were applied until all the symptoms are cleared. We followed the patients for 2 years for the recurrence of symptoms and signs.
RESULTS All patients had immediate relief of symptoms once the brace was applied. After the dislocation of braces, 15 of 21 patients did not have any recurrences for 2 years. Six patients had recurrence of pain and ingrown nail and were willing to use the brace once more instead of having any operations.
CONCLUSION Nail brace application is a safe, simple, and inexpensive treatment option for diabetic patients with ingrown toe nails. Although there may be recurrences, patients are willing to use it for a second time as it is simple and pain free.     

足嵌甲的整复手术治疗研究

作为临床常见足部疾病,足嵌甲可导致足趾甲周围剧烈疼痛,同时对患者日常活动和生活造成 严重影响。目前临床治疗足嵌甲的方法较多,但对于采取何种治疗方式尚未统一,如治疗方式选取不当, 不但无法发挥理想治疗效果,而且患者治疗后易复发。因此,需根据患者疾病情况和患者实际情况采取科 学治疗方案,从而实现有效治疗。本文主要对足嵌甲症病因和分期、治疗方案的选择进行综述,以期为足 嵌甲临床治疗提供思路。     

改良Winograd术治疗(足母)趾嵌甲症

(足母)趾嵌甲症是外科门诊的常见病,自1994年5月～1998年10月,笔者应用改良Winograd术治疗27例（足母）趾嵌甲症,效果良好,总结如下. 1 病历资料 1.1 一般资料 本组男10例,女17例,平均年龄26(16～56)岁.平均病程3.2(2～7)年.单趾发病者16例,双趾发病者11例,共44处.Frost分型[1]:趾甲正常但甲刺或甲钩长入周围组织者24例(38处);趾甲正常甲唇肥大阻塞甲沟者2例(2处),趾甲侧缘内翻生长压迫甲沟内组织者1例(4处).并发甲沟炎者5例,合并甲癣者4例.     

Modified Sleeve Method Treatment of Ingrown Toenail

BACKGROUND: Ingrown toenail is a common problem that causes inconvenience, pain, and limitation of daily function. Current conventional treatment methods are not satisfactory and have a high recurrence rate. OBJECTIVE: To evaluate a modification of an existing, although uncommonly used, method for treating ingrown toenail. METHODS: Patients with ingrown toenail were treated under local anesthesia by insertion of a flexible narrow plastic tube under the toenail along its lateral border. Tube fixation was performed with silk or nylon 2-0 sutures passed through the toenail. Granulomatous and inflamed tissue was removed by electrocautery or local excision. RESULTS: Twenty-eight procedures were performed in 25 patients. In 20 procedures (71.4%), no recurrences were recorded; the other 8 procedures (28.6%), were symptomatic. CONCLUSION: This method for the treatment of ingrown toenail was found to be simple and efficient, with a relatively low recurrence rate. Therefore we currently advocate this procedure as the treatment of choice.     

Surgical Treatment of Ingrown Toenail without Matricectomy

BACKGROUND Partial excision of the nail matrix (matricectomy) is generally considered necessary in the surgical treatment of ingrown toenail. Recurrences may occur, however, and poor cosmetic results are frequently observed.
OBJECTIVE The objective is to present a new surgical procedure for ingrown toenail with complete preservation of the nail matrix.
METHODS Twenty-three patients with ingrown toenail were included in this study. The surgical excision was performed 1 week after the completion of treatment of the initial infection. A large volume of soft tissue surrounding the nail plate was removed under local anesthesia. No matrix excision was performed.
RESULTS Short-term results were excellent. No recurrences or severe complications were observed during the minimum 12-months follow-up period. Cosmetic results were remarkable.
CONCLUSIONS Ingrown toenail results from the compression of the lateral nail folds on the nail plate. This study shows that ingrown toenail can be surgically treated without matricectomy. A large volume of soft tissue surrounding the nail plate should be removed to decompress the nail and reduce inflammation. Cosmetic results are excellent and superior to the classical Emmert plasty. Postoperative nail dystrophies and spicule formation are not observed. The main advantage of this surgical approach is the complete preservation of the anatomy and function of the nail to improve both therapeutic and cosmetic results.