PNA – Ingrown toenail surgery

Nail Surgery (Partial Nail Avulsion) may be required when an ingrown toenail repeatedly gets infected, is continually painful, the patient is unable to wear shoes or the condition inhibits work, sporting or other activities.

Before surgery is recommended, we will explore other conservative treatment options first as surgery is not suited to everyone. In some cases ingrown toenails are easily removed during a general treatment with minimal pain and without the need for local anaesthetics.

Nail surgery performed by Sole Therapy podiatrists

A ‘Partial Nail Avulsion’ (known as a PNA or nail root and matrix resection) is a minor nail procedure, which aims to permanently treat ingrown toenails. The procedure is performed in our clinic rooms, takes around one hour and you are able to walk immediately afterwards.

What does a partial nail avulsion involve?

We will conduct a complete assessment, taking a medical history, a list of any medications that have been prescribed for you as well as considering any other clinical factors that will determine whether or not this surgery is suited to you. An assessment will generally also include an examination of blood supply to the foot.

The procedure itself is performed under local anesthetic via injection into the toe to numb the area. The anesthetic will wear off in about two hours. Once numb, a tight elastic ring called a tourniquet is applied to the toe to control bleeding and the area is prepped to minimise the risk of infection.

The offending portion of the nail is then gently lifted and trimmed away, generally without the toe being cut or stitched. Both sides or the entire nail may be removed this way. A chemical may also be used at this point to assist in preventing nail regrowth.

Once the procedure is completed, the tourniquet is removed and a sterile surgical dressing is applied. You are able to walk immediately afterwards, however assistance getting home is strongly recommended as we do not recommend driving directly after the surgery.

What happens after the procedure?

The first two re-dressings are conducted in our clinic and you then continue to re-dress at home there after. Extra consultations may be required over the two-four weeks following the procedure if pain or infection is still present. For the first few days after the procedure we recommend the use of open toed shoes and activity modification may be necessary, however interference with day-to-day activities is generally minimal.

What are the potential complications?

As with any surgical procedure there is some risk of complication, however this procedure is known to be very safe and effective.

The most common side-effects are post-operative infection in the short term and the possibility of regrowth of the nail over time. The risks of infection can be minimised through good post-operative care and we will give you advice and assist with your situation so your potential complications risk is very minimal.