#onychocryptosis

Article Summary

Abstract

Introduction

Ingrown nail (onychocryptosis) is a common condition. Risk factors are well-defined and include ill-fitting shoes, faulty nail trimming, hyperhidrosis, poor foot hygiene, and genetics. Repeated trauma has been proposed as a cause. Ingrown nails are most commonly found on the first toes where the joints bear the most pressure.

Joint hypermobility has been shown to modify an individual's gait includings an increase in pressure in the medial midfoot region. Orthopedic foot problems like pes planus are common in hypermobility patients.

Generalised joint hypermobility (GJH) is a major component of joint hypermobility syndrome (JHS) which has other features that may make individuals more proned to ingrown nails such as fragile and thin skin, autonomic and proprioceptive sensory neuronal dysfunction (resulting in hyperhidrosis and vulnerability to recurrent trauma).

The Beighton criteria has been used for the assessment of GJH but has been criticised for only including certain joints and lacking consideration for associated symptoms or conditions.

This study aims to investigate the association between hypermobility and ingrown nails and the hypothesis that local hypermobility might play a role in its occurence.

Materials and methods

Details the criteria for inclusion and exclusion of patients in the study and the control group. Assessments were made using the Beighton criteria and measurements of local hypermobility.

Discussion

Ingrown nails is a common condition with peak occurences at two distinct age ranges suggesting differing causes

Several predisposing factors have been identified including a positive family history. Joint hypermobility has similarly been shown to be familial

Ingrown toe nails are more common in patients with GJH and are associated with more limited mobility of the first toe. This is counterintuitive but GJH predisposes individuals to repeated trauma, a risk factor for ingrown nails.

Hallux limitus/rigidus has been associated with first toe hypermobility. Pregnancy and obesity are also risk factors for hallux limitus/rigidus. Ingrown nail formation is also common in dancers and other sports people.

GJH is a fundamental part of JHS but JHS has other characteristics that could not be assessed in this study but could contribute to ingrown nail formation

Joint hypermobility is more common in children and less so in the elderly as a result of related complications so patients over 50 were not included in this study but could be included in further studies to strengthen this study's position.