We have already talked about nail retraining with titanium wire, a technique to correct nail shape and reduce and prevent ingrown nails.
Another ally the podiatrist has is acrylic resin reconstruction, a modern orthotonixia technique.
Contrary to common thinking, nail reconstruction, especially of the feet, is not only a cosmetic treatment but primarily a medical one, the lamina being a very important apparatus for walking and protecting the foot.
The nail plays a primary protective role, primarily by shielding the small bones of the distal phalanx from accidental microtrauma and by distributing the load of shoe forces across a greater bearing surface than the toe tip alone, equalizing the compressive load to the bones and underlying soft tissues.
Why resort to acrylic resin reconstruction?
There are many reasons why a phalanx may remain uncovered, trauma with total or partial nail breakage, psoriasis, onychomycosis, ingrown nail, or growth-altering onychopathies. In the absence of the lamina, the finger tends to assume a peculiar shape, known as a “babbit” finger, that is, where the tissue at the tip of the phalanx due to the pressure exerted by the finger to the ground and the ground reaction forces tends to form a fibrous cap in the area originally occupied by the nail.
This fibrous tissue will prevent proper growth of the nail, which will undergo anterior incarniation and change the distribution of loads in the finger, causing a bony growth reaction in the tip of the phalanx known as exostosis.
This process will also alter the patient’s biomechanics, that is, their posture and the way they walk, as well as being painful.
Therefore, it is important to prevent the nail from losing its natural seat by intervening with the right timing in case of breakage and/or altered growth. It is also an essential treatment in the aftercare of ingrown toenail, especially in patients with hypertrophic periungual rim that tends to cover the nail quickly.
The resins used are acrylic, elastic, hypoallergenic and with antifungal components, opaque clear or tending to the natural color of other nails. It is a painless treatment and involves covering the nail bed with these resins using a piece of adjoining nail as a scaffold.
They perform the same function as the natural nail and should be renewed periodically to check that the therapy is correct. They can be covered with polish after evaluation by the podiatrist and also serve as an aesthetic treatment in many cases, dystrophic toenails being an embarrassment for many.
