Comparison of outcomes of banding, nail brace, and Winograd techniques in the treatment of ingrown toenails

Abstract

Aims: This study aims to evaluate the clinical outcomes of three commonly used treatment methods—banding, nail brace, and the Winograd procedure—in patients with Heifetz stage 2 ingrown toenails. Parameters such as recurrence rate, infection rate, postoperative pain, and patient satisfaction were assessed to guide clinical decision-making. Methods: This retrospective study included 91 patients diagnosed with Heifetz stage 2 ingrown toenail, who were treated using one of three methods. Patients were divided into three groups: banding, nail brace, and Winograd procedure. Visual Analog Scale (VAS) scores were recorded on the third postoperative day to assess pain levels. The short-term outcomes, recurrence rates, and complications were analyzed. Ethical approval was obtained and the study adhered to the principles of the Declaration of Helsinki. Results: The nail brace method showed a significantly shorter return-to-work duration (mean 10.2±9.5 days) compared to the Winograd procedure (19.0±6.4 days, p<0.001). Postoperative pain levels were significantly lower in the nail brace group (VAS score: 4.1±1.3) than in the Winograd group (6.0±1.5, p<0.001). Recurrence rates were similar across the nail brace (25.0%), Winograd (15.0 %), and banding (26.1%) groups (p=0.472). No significant differences were observed in the postoperative infection rates between the two methods (p=0.571). Conclusion: The nail brace method offers faster recovery, shorter return-to-work durations, and lower postoperative pain, making it a less invasive alternative to the Winograd technique, which has longer recovery times. Despite these differences, both methods show similar recurrence rates, highlighting the need for treatment selection based on patient characteristics and preferences. Further studies with larger samples are required to assess long-term outcomes.

Keywords

• Ingrown toenail nail brace
• Winograd technique
• recurrence
• postoperative pain

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