A 21-year-old girl presented at Leading Edge Podiatry with an involuted toenail in her right big toe. She reported that the pain had been present for several years and had gradually worsened over time. She was otherwise healthy and did not take any medication. She was a keen dancer and had been unable to dance due to the pain. The patient had seen another podiatrist who discussed nail surgery but the patient wanted to try a conservative measure first.
Patient’s Pain Symptoms
The patient reported that the pain was present in her right big toe. The onset of pain was when she first noticed the nail growing into the skin. The pain was initially mild but gradually worsened over time. The pain was worse when wearing shoes and when dancing. The patient described the pain as a sharp, stabbing sensation in the toe.
Examination and Assessment
The podiatrist examined the curvature of the nail. It appeared involuted at the corner and digging into the skin. There was no sign of infection and the patient was sore only at the tip of the corner of the toenail.
Diagnosis and Treatment
The podiatrist diagnosed the patient with an involuted toenail. The severity was moderate and the recommendation was to apply Onyfix nail brace to the toenail. Before applying the Onyfix nail brace, the podiatrist trimmed and filed the nail. The Onyfix nail brace was applied at the edge of the nail closest to the cuticle. The patient was advised the Onyfix nail brace will grow out with the nail and as it does, it will help reduce the involuted edge.
The patient was advised to rest from dancing for a few weeks and to avoid any other activities that caused pain. The patient was reviewed every 8 weeks to see how the nail was growing. The nail reduced in involution and the corners of the nails were no longer painful. After 8 months the Onyfix nail brace came off and the patient no longer has pain in the corner of her toenail.
