China Journal of Leprosy and Skin Diseases ›› 2025, Vol. 41 ›› Issue (7): 498-502.doi: 10.12144/zgmfskin202507498

• Clinical Researches • Previous Articles     Next Articles

Bilateral perionychial flap excision combined with distal soft tissue reduction technique for treating severe chronic paronychia of the great toe

LI Zhendong1, ZHOU Haichao1, ZHAO Youguang1, XIA Jiang1, LI Bing2, YANG Yunfeng2   

  1. 1 Department of Orthopedics, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China; 2 Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2025-07-15 Published:2025-07-04

PDF (PC)

67

Like

Abstract: Objective: To study the clinical efficacy of bilateral perionychial flap excision combined with distal soft tissue reduction in the treatment of severe chronic paronychia of the great toe. Methods: Clinical data of patients with chronic severe paronychia who visited the Department of Orthopedics at Tongji Hospital of Tongji University from January 2021 to December 2022 were collected. All patients were treated with soft tissue reduction technique and followed up for 12 months postoperatively. Preoperative and postoperative visual analogue scale (VAS) scores for pain and Dermatology Life Quality Index (DLQI) scores were evaluated, along with patient recurrence, postoperative complications, and personal satisfaction. Results: A total of 55 patients with 67 affected toes were analyzed, including 39 males and 16 females, with an average age of (23.1±10.3) years. Among them, 43 had unilateral involvement, and 12 had bilateral involvement, with 35 toes affected on the left side and 32 on the right side. The VAS scores at first and twelfth months after the operation were (1.02±0.12) and (0.10±0.05), and the DLQI scores were (6.75±2.13) and (1.45±0.87) respectively, with significant differences compared to the preoperative VAS (6.11±0.89) and DLQI (16.23±3.34) (Ps＜0.001). After the operation, wound infection and inflammatory response occurred in 3 cases, and they recovered after repeated dressing changes and antibiotic treatment. Recurrence occurred in 2 cases after the operation, with symptoms of nail entrapment and pain, and the symptoms improved after a period of treatment with Ω wire and cotton filling. The patient satisfaction at first and twelfth months after the operation was 81.8% and 92.7% respectively. Conclusions: Bilateral perionychial flap excision combined with distal soft tissue reduction is an effective treatment for severe chronic paronychia of the great toe, with low rates of postoperative complications and recurrence, and high patient satisfaction.

Key words: paronychia, surgical procedures, soft tissue reduction, acronyx