Infected ingrown toenails raise the question of how much nail should be removed and what amount of nail fold reduction should occur. Often, the ungual labia folds are found to be hypertrophic, forcing the nail to push into the flesh and start a foreign body reaction. A simplified approach to this problem is proposed on the basis of the measurement of 100 normal nail folds and 25 infected nail folds. The results of this study show that the treatment goal should be to achieve an ungual labia fold of less than 3 mm, concluding that there is a correlation between the depth of the ungual labia fold and the severity of the infected ingrown toenail. (J Am Podiatr Med Assoc 92(3): 131-135, 2002)
Background: Dilute alcohol injection has been described as a nonsurgical treatment option for interdigital nerve compression of the foot, also known as “Morton’s neuroma.” This study reviews the efficacy of the procedure in 49 feet at one treatment center.
Methods: In this historical cohort study, data from 42 patients who had undergone alcohol injection therapy were obtained from clinic records. A total of 49 feet were reviewed.
Results: Symptoms were improved or resolved in 30 (61%) of 49 feet. Nineteen feet (39%) were unimproved, with 12 of those progressing to surgical neurectomy. Feet that received five or more injections were more likely to improve (74%) than those that received fewer than five injections (39%). Three patients reported mild complications associated with dilute alcohol injection, all of which resolved spontaneously within 2 days of the injection.
Conclusions: Dilute alcohol injection is a safe and effective treatment option for patients with Morton’s neuroma who want to avoid a surgical procedure and any associated complications. The procedure may be more successful if the patient receives at least five injections. (J Am Podiatr Med Assoc 97(3): 203–206, 2007)
Ledderhose disease (plantar fibromas) is histologically related to Dupuytren disease, which has been successfully treated for years with radiotherapy. Many conservative treatments have been advanced for plantar fibromas, including accommodative orthotic devices, which help but do not cure the disease. Surgery is considered the mainstay of treatment for this malady, but the failure rate has been as high as 100%, depending on the type of fasciectomy. Radiotherapy is a new, exciting modality that has shown promising results for treating plantar fibromas.