What is the purpose of toenail (onychial) bracing?

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From the Research

Toenail bracing is a highly effective non-surgical treatment for ingrown toenails and should be considered as a first-line treatment for mild to moderate cases. The procedure involves applying a specialized hook, wire, or composite resin brace to the nail that gently lifts and reshapes it over time, guiding it to grow over the skin rather than into it. According to a study published in the Journal of the American Podiatric Medical Association 1, nail bracing has a high success rate for permanent correction when completed properly, with a mean time to return to work of 4.15 days, which is significantly shorter than that of surgical treatments.

Key Benefits of Toenail Bracing

  • High patient satisfaction rate of 94.6% 1
  • Low recurrence rate of 8.1% 1
  • Fast recovery times, with patients able to wear regular shoes again without appreciable pain much earlier than those undergoing surgical treatments 2
  • Preserves the natural nail, avoiding the pain and potential complications of surgery
  • Can be used for prolonged periods of time, with reapplication of bracing usually required if recurrence occurs 3

Treatment and Home Care

  • Treatment usually lasts 3-6 months, with follow-up appointments every 4-6 weeks to adjust the brace as the nail grows
  • For home care, keep the area clean and dry, avoid tight footwear, and take over-the-counter pain relievers like acetaminophen or ibuprofen as needed for discomfort
  • Nail bracing works by applying constant gentle tension to flatten the natural curvature of the nail, allowing the edge to grow past the skin fold without embedding

Important Considerations

  • Severe cases with significant infection may still require surgical intervention
  • Nail bracing is an effective therapeutic option, particularly for chronic dystrophic (CD)-type ingrown toenails, with an excellent or fair outcome at 6 months of 100% 4

References

Research

Nail Braces as an Alternative Treatment for Ingrown Toenails: Results From a Comparison With the Winograd Technique.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2015

Research

Ingrown toenails (unguis incarnatus): Nail braces/bracing treatment.

Proceedings (Baylor University. Medical Center), 2014

Research

Efficacy of a new nail brace for the treatment of ingrown toenails.

Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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