Is Winograd technique an effective method in the treatment of ingrown toenails among pediatric population?

INTRODUCTION: This study aimed to examine the results of the winograd technique applied in the treatment of ingrown toenail cases, which are frequently encountered in childhood, especially in adolescence. The recurrence, satisfaction, and complication rates in the pediatric age groups were evaluated with the surgical matrixectomy application of winograd technique, a frequently used one in the adult age groups.
METHODS: Ingrown toenail cases that had undergone surgical matrixectomy with Winograd technique between September 2016 and December 2018 were evaluated. Those detected to be stage 2-3 according to the Heifetz classification were operated. Demographic information was recorded. The cases were divided into three groups as 3-7, 7-12, and ≥12 by age groups. Such data as recurrence, post-operative infection, osteomyelitis, long term complication and return to the regular activity were evaluated. Visual Analog Scale was used for the satisfaction scale.
RESULTS: A total of 162 operated ingrown toenails from 142 children were followed for an average of 21 months (12-38). The mean age was 13.8. When the ingrown toenail location was evaluated, the lateral sides (98, 61.2%) of the patients were seen to have been affected more. According to age groups 65% (105) of the cases were in the group aged 12 and over. While the frequency of all complications was 8.1% (13), no chronic complications or osteomyelitis were encountered. Recurrence was observed in 3.1% of cases and also early infection (<15 days) was observed in 10 cases, while the late infection (≥15day) was observed in 3 cases. According to the visual analog scale scores, 135 (95.0%) cases were found to be very satisfied or satisfied.
DISCUSSION AND CONCLUSION: Winograd technique (surgical matrixectomy) is of low recurrence, low complication and high satisfaction rates in all pediatric age groups even with advanced ingrown toenail complaints. Complete excision of affected matrix with magnification increases the success of the Winograd technique.