Medical Terms for Toenail Removal
The medical term for the removal of a toenail is onychectomy, which refers to the complete surgical excision of the nail plate. 1
Types of Nail Removal Procedures
- Onychectomy: Complete surgical removal of the nail plate 1
- Partial onychectomy: Removal of only a portion of the nail plate, often used for ingrown toenails 2
- Nail avulsion: A broader term that encompasses the removal of the nail plate from the nail bed, which can be performed either surgically or chemically 1
- Matricectomy: The removal or destruction of the nail matrix (the tissue that produces the nail), resulting in permanent nail loss when complete 3
- Partial matricectomy: Removal of only a portion of the nail matrix, usually the lateral horns, to prevent regrowth of problematic sections of nail 3
- Nail ablation: The definitive removal of the entire nail organ, including the nail plate, matrix, and sometimes surrounding tissues 3
Indications for Toenail Removal
- Onychomycosis: Fungal nail infections that are resistant to topical or oral antifungal treatments 4
- Onychocryptosis: Commonly known as ingrown toenail 5
- Chronic paronychia: Persistent infection of the tissue surrounding the nail 1
- Onychauxis: Abnormal thickening of the nail 3
- Onychogryphosis: Severe nail deformity with thickening and curvature 3
- Nail tumors: Both benign and malignant 1
- Subungual hematoma: Blood collection under the nail that causes severe pain 4
- Subungual abscess: Infection under the nail plate 4
- Retronychia: Ingrown nail where the proximal portion embeds into the proximal nail fold 1
Surgical Techniques for Nail Removal
- Distal approach: The most common surgical technique for nail avulsion, where the nail is separated from the nail bed starting at the free edge 1
- Winograd technique: Partial nail avulsion with matricectomy for ingrown toenails 5
- Chemical matricectomy: Using chemicals (typically phenol or sodium hydroxide) to destroy the nail matrix after nail avulsion 5
- Zadik's procedure: Complete nail and matrix removal 5
- Vandenbos procedure: Focuses on removing the periungual soft tissue rather than the nail 5
Anesthesia for Nail Removal
- Most nail removal procedures are performed under local anesthesia 1
- Digital nerve blocks are commonly used, with or without epinephrine (1:200,000 dilution) 1
- For painful conditions like subungual hematoma, anesthesia is essential before nail removal 4
Post-Procedure Management
- Cleaning the nail bed and obtaining cultures if infection is suspected 4
- Appropriate topical or oral antibiotics for any identified infections 4
- Regular nail trimming during regrowth to prevent recurrence of issues 4
- Application of topical emollients to promote healing 4
Complications of Nail Removal
- Infection of the exposed nail bed 1
- Regrowth abnormalities if the matrix is damaged but not completely destroyed 3
- Nail spicule formation (sharp, painful nail fragments) 6
- Postoperative nail dystrophies 6
- Recurrence of the original condition if the procedure is not performed properly 5
Preventive Measures
- For patients undergoing treatments that may cause nail toxicity (e.g., taxanes), preventive measures include: