MNT Ingrown Toenail Management 1 — Questions and Answers
Question 1: The medical term for an ingrown toenail is:
- Onychauxis
- Onychocryptosis (Correct answer)
- Onycholysis
- Paronychia
Correct answer: Onychocryptosis
Onychocryptosis describes the condition where the nail plate edge penetrates the lateral nail fold, causing pain, inflammation, and potential infection.
Question 2: Which nail-cutting technique most commonly causes ingrown toenails?
- Cutting straight across
- Cutting the corners too short or rounding the nail edges (Correct answer)
- Leaving the nail too long
- Filing the dorsal surface
Correct answer: Cutting the corners too short or rounding the nail edges
Cutting the corners too short removes the nail's structural support from the groove, allowing the nail edge to grow downward into the periungual tissue.
Question 3: Stage 2 ingrown toenail is characterized by:
- Pain only with pressure, no visible inflammation
- Infection with purulent drainage and granulation tissue formation (Correct answer)
- Complete nail avulsion required
- Only minor nail fold erythema
Correct answer: Infection with purulent drainage and granulation tissue formation
Stage 2 (Mozena/Heifetz classification) involves active infection with pus, significant swelling, and hypergranulation tissue forming at the nail fold.
Question 4: Conservative management of a Stage 1 ingrown toenail may include:
- Immediate partial nail avulsion
- Cotton wool packing under the nail edge and warm saline soaks (Correct answer)
- Systemic antibiotics as first-line treatment
- Full nail removal
Correct answer: Cotton wool packing under the nail edge and warm saline soaks
Stage 1 (early, non-infected) ingrown toenails can be managed conservatively by inserting cotton or foam under the lateral nail edge to redirect growth away from the fold.
Question 5: Which patient population requires the most cautious approach when performing nail edge elevation for an ingrown toenail?
- Young adults with no comorbidities
- Diabetic patients and those with peripheral vascular disease (Correct answer)
- Athletes with sports-related ingrowth
- Children under 10
Correct answer: Diabetic patients and those with peripheral vascular disease
Diabetic and PVD patients have impaired healing and reduced sensation; even minor nail fold trauma can lead to infection, ulceration, or limb-threatening complications.
Question 6: Phenol-alcohol ablation following partial nail avulsion is performed to:
- Disinfect the nail groove
- Chemically destroy the nail matrix cells to prevent nail regrowth along the treated border (Correct answer)
- Stimulate healthy nail regrowth
- Seal the wound after avulsion
Correct answer: Chemically destroy the nail matrix cells to prevent nail regrowth along the treated border
Phenolization of the nail matrix after partial nail avulsion permanently destroys germinal cells in the treated segment, preventing recurrence of the ingrown nail edge.
MNT Ingrown Toenail Management 1
The medical term for an ingrown toenail is: