Orthonixia or nail retraining is the branch of podiatry that deals with correcting deformities of the nail plate.
Nail deformities and particularly increased curvature are the cause of about 20% of podiatric problems in the population.
These deformities can present to both feet in a symmetrical form and are caused by congenital factors peculiar to the nail, such as shape, thickness, width, and hypertrophic periungual edges; however, if they are unilateral and occur in adulthood, the cause must be sought in external factors such as postural changes, foot or toe deformities, and trauma.
Other factors that act as concauses include the shape of footwear, sweating and certain types of athletic gestures, especially in children and young people.
It is a problem that occurs almost exclusively in the first toe; if the smaller toes are affected, it is related to deformities such as hammer toes or hallux valgus.
The treatment of ingrown toenails (Onychocryptosis) and Onychophosis
Thus, reeducation is essential in all nail pathologies in which altered nail curvature causes pain, callosity in the periungual vallus (onychophosis) or lateral nail ingrowth (onychocryptosis).
The rehabilitation methods that can be used are varied; the choice of the most appropriate therapy for the patient is made taking into consideration several factors such as the initial problem, pain, nail morphology, timing of application, concomitant local or systemic pathologies.
These are painless techniques, which should be offered after the acute pain is resolved. Their function is to restore the nail to a “normal” curved condition so that it does not cause pain to the surrounding tissues. It plays an important role in preventing the recurrence of all the above diseases.
They are bloodless methods, that is, they do not involve anesthesia or injury to the skin or nail to be inserted.
They are also conservative methods, that is, they do not permanently change the shape of the nail but preserve its function and width, giving them the ability to be repeated as often as necessary.
What techniques are used for the prevention of Onychophosis and ingrown nails?
There are many techniques available to the practitioner and they have evolved over the years, becoming increasingly effective, with a low rate of recurrence of the problem and limiting the need for surgical intervention.
– Splitting using single or double nickel-titanium wires
– Barret-spange method: glass lamellae – return memory resin
– Nail reconstruction with medical resin
All three techniques are found to be effective and minimally traumatizing to the nail plate, thus being noninvasive, comfortable, and painless. The reeducation technique using Nickel-Titanium wires and light-curing resins uses tools already used in dentistry and is the most proven in the scientific literature as well.
The reeducation methods also do not involve restrictions regarding footwear or work and sports activities.
Treatment in special cases of biomechanical or postural derivation offers better results in conjunction with customized orthotic foot therapy, which prevents external forces acting on the nail from continuing to cause it to curve incorrectly.
In any case, podiatric therapy cannot be limited to reeducation alone but must go to eliminate all those conditions that may cause the problem to recur.
In cases of severe deformity that cannot be resolved with rehabilitation, there are ambulatory surgery techniques that can eliminate the problem by permanently reducing the width of the nail. In this case, the podiatrist will work as a team with the dermatologic surgeon and follow the patient in the pre- and post-operative period.
A visit to the podiatrist allows you to get a clearer view of the problem and a personalized solution that will allow you to stop suffering!
By contacting the podiatry department of Airam Medical Center, located at 165 Via Lame in Castel Maggiore (BO), you will be able to book a visit with our specialists and prevent or treat your uvual pathologies, prevention and treatment will be entrusted to our team of experts, with proven professionalism and excellence in the field.
