Matrix Phenolization vs Gutter Splint Method for the treatment of onychocryptosis: a randomized open-label study

Background
Treatment of ingrown toenails includes conservative and surgical approaches. The aim of this study was to compare the efficacy and tolerability of the Gutter Splint (GS) method with the reference technique: matrix phenolization (MP).
Methods
We conducted a randomized, open-label, two-arm parallel study, enrolling 110 consecutive patients presenting with ingrown toenails. Outcome measures included duration of the procedures, postoperative pain, and resumption of usual daily activities at day 7, recurrence rates at 4 and 12 months, and complications. Both descriptive and analytical statistics were performed.
Results
A hundred and ten cases were consecutively randomized to receive segmental MP (54 patients) or GS method (56 patients). The duration of the procedure was significantly lower in the GS group compared with MP (12.77 ± 2.6 min vs 15.52 ± 5 min, P=0.001). Recurrence rates were 2.3% and 2.4% at 4 months (P>0.05) and 21% and 10.8% at 12 months (P=0.34) 43 in GS and MP groups, respectively. There was no statistical difference in recurrence rates or complications between these two groups.
Conclusions
This study, the first randomized trial comparing GS and MP techniques for ingrown toenails, demonstrated comparable recurrence rates at 4 months. The GS group showed an increase in recurrence rates at 12 months (P=0.34). The GS technique appears to be a promising alternative to MP in the management of onychocryptosis and has the advantage of preserving the normal anatomy of the nail unit but relay havily on patients’ compliance.