Surgical techniques involve removing the pressure of the nail plate on the nail fold by excising all or part of the nail plate or excising all or part of the nail fold.
Surgical procedures for ingrown toenails include the following: partial nail avulsion (Ross procedure) with or without partial matrixectomy; wedge excision, segmental wedge excision, or wedge resection with destruction of the nail matrix (Winograd procedure); total nail avulsion with or without excision of any granuloma with or without total excision (chemical or surgical) of the matrix (Zadik procedure); rotational
nail fold flap technique; or radical excision of the nail fold (Vandenbos procedure).
The most common procedure for treating locally ingrown toenails is partial avulsion of the lateral edge of the nail plate sometimes followed by lateral horn matrixectomy by phenolization or surgical excision of the lateral horn of the nail matrix, both of which are equally effective. Whenever possible, partial avulsion of the nail plate is preferred over complete avulsion because it minimizes trauma to adjacent tissues.