Abstract
Introduction: We present the results of a prospective randomized trial of Zadik’s procedure V. chemical ablation by sodium hydroxide for the treatment of ingrowing toenails.
Materials and Methods: Thirty eight patients had Zadik’s procedure, 45 patients had chemical ablation by sodium hydroxide. Mean average follow-up was 12.45 months for Zadik’s group and 11.69 months for the chemical group.
Results: We have studied 5 end points: 1/return to normal shoe wear. In Zadik’s group, the average return to normal shoe wear was 2.13 weeks and 3.73 weeks in the chemical group. 2/average return to normal activity was 2.18 weeks for Zadik’s group and 3.89 for the chemical group. 3/the median numbers of dressings were 3 and 8 for Zadik’s and chemical ablation patients respectively. 4/the pain score, using the visual analogue, were not statistically significant between the two groups. 5/the recurrence rate, 23 recurrences in Zadik’s group (60.5%) and seven recurrences in chemical ablation group (15.6%). However, only 13 patients had symptomatic recurrence (34.2%) in the Zadik group and two patients had recurrence in the chemical ablation group (4.4%). 6/economic implications are considerable if we to compare the surgical ablation against the much cheaper chemical ablation.
Conclusion: The use of chemical ablation by sodium hydroxide in the treatment of ingrowing toenails shows statistically significant reduction in the recurrence rate of ingrowing toenails compared to Zadik’s procedure (P< 0.05).
Honorary Secretary Mr Bimal Singh. Correspondence should be addressed to BOSA (British Orthopaedic Specialists Association), c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PE.
