The effectiveness of nail excision versus Vandenbos procedure for the surgical management of ingrown toenails in children: A retrospective chart review.

Background: Ingrown toenail commonly occurs in patients who have experienced trauma or long-term compression to their toes. There exist two common methods of surgical management - wedge resection and Vandenbos procedure. We compared the recurrence rate of these two methods in pediatric patients.

Methods: We conducted a retrospective study reviewing patients who presented to our institution with ingrown toenail between 2009 and 2015. Patients who received any surgical treatment outside of our institution or were over 18 years of age were excluded.

Results: There were 523 patients seen at our institution with ingrown toenail. Of these patients, 482 had sufficient data available to be included in this study, with a total of 929 ingrown toenails. Out of these, 333 were managed conservatively while the remaining 596 required surgical intervention; 373 had wedge resection performed and the other 223 had Vandenbos procedure. Our analysis determined that 78 total complications arose in the wedge resection group (21%) while 32 total complications arose in the Vandenbos group (14%; p = 0.0949). Wedge resections had a significantly higher recurrence rate than Vandenbos procedures (41 (11%) vs 5 (2%), p = 0.0001).

Conclusion: Surgical complications are comparable between wedge resections and Vandenbos procedure. Vandenbos procedure offers a significantly lower recurrence rate than wedge resection.

Level Of Evidence: Level III.