From the Research
No, toenail removal does not count as an open fracture. An open fracture specifically refers to a broken bone that has penetrated through the skin, creating an open wound that exposes the fractured bone to the external environment. Toenail removal, whether partial or complete, involves only the nail plate and potentially the nail bed, but does not involve any bone fracture.
Key Points
- Toenail removals are classified as soft tissue procedures that affect the nail apparatus, which consists of the nail plate, nail bed, nail matrix, and surrounding soft tissues.
- Even when a toenail removal is performed surgically (onychectomy), it remains distinct from fracture management.
- The distinction is important because open fractures require urgent medical attention to prevent bone infection (osteomyelitis), while toenail removals typically require wound care to prevent soft tissue infection and proper healing of the nail bed.
- Various surgical techniques are available for ingrown toenails, including the Winograd technique, Vandenbos procedure, and chemical matricectomy, as discussed in a recent review 1.
- The choice of procedure depends on the severity and recurrence of the ingrown toenail.
- It is essential to prioritize wound care and prevent soft tissue infection in toenail removals, rather than treating them as open fractures, to minimize morbidity and mortality, and improve quality of life.