An ingrown toenail, also called onychocryptosis, results from cutting the toenail too short or improperly, causing pain and discomfort that can impede walking.
Most ingrown toenails can be treated at home, but complications may require a podiatrist’s intervention, often recommending a matricectomy procedure.
This article explains the surgical procedure used to remove ingrown toenails.
Assessment of the Toe and Foot
Before choosing a treatment like matricectomy, the podiatrist diagnoses the ingrown toenail by identifying symptoms such as:
- Difficulty dressing comfortably;
- Toe pain, especially when walking;
- Discomfort lasting more than two weeks;
- Redness;
- Swelling or purulent infection (paronychia).
Once these signs are confirmed, the podiatrist evaluates the infection stage and plans treatment.
The Chosen Intervention Method
The podiatrist considers symptom severity, existing health issues, and the chance of recurrence before recommending matricectomy.
If the condition allows, less invasive methods such as medical nail cutting or orthonyxia are tried first.
If these methods fail, surgical removal via matricectomy may be necessary (learn more).
Preparing the Foot
Pre-surgery instructions from the podiatrist typically include:
- Understanding the procedure and what it entails;
- Disinfecting the foot within 24 hours before surgery;
- Taking prescribed medications at least one hour prior, if directed.
The Surgical Procedure
Upon admission, the medical team reviews the surgical plan. The matricectomy procedure generally involves:
- Administering local anesthesia (lasting 1 to 6 hours depending on the case);
- Cleaning and disinfecting the toe;
- Applying a tourniquet at the toe base if needed;
- Gently pulling back the nail with a surgical spatula;
- Cutting away the problematic nail portion (2 to 5 mm);
- Using a chemical method (phenolization) to destroy the nail matrix, if necessary;
- Disinfecting the area with alcohol or saline;
- Applying antibiotic solution, gauze bandage, and waterproof dressing.
Postoperative Measures
This minor foot surgery uses local anesthesia, allowing discharge the same day.
Postoperative care instructions must be followed carefully:
- Avoid wetting the foot in the hours after surgery;
- Disinfect the wound for 2 to 3 weeks;
- Refrain from physical activity for 7 days post-matricectomy;
- Wear shoes that minimize pressure on the toe and heel.