Ingrown toenails of the big toe are a rare problem in babies. In this report, four cases of congenital ingrown toenail are presented. Congenital means the problem was present at birth.
In all four babies, the ingrown toenail was bilateral. This means it was present on both sides. The toes were painful and in some cases, red and swollen.
There was no known family history of ingrown toenails. All the children were healthy otherwise. One child had another medical condition called Dandy-Walker syndrome. This did not appear to be linked with the ingrown toenails.
At first, treatment was conservative. Antibiotics were used for infection. Warm soaks and pushing the soft tissue away from the nail bed were tried. Only one case resolved with this treatment. The nonsurgical approach took months. In three of the four cases, symptoms persisted and surgery was finally needed.
The surgeon removed the extra soft tissue growing over the nailbed. This is called a wedge resection. The results were excellent. The problem went away in both feet. No one required any further treatment.
The authors conclude that although ingrown toenails are rare at birth, surgical treatment can be safe and effective. After a prolonged period of conservative care, if inflammation and infection don’t go away, then the extra flap of tissue can be removed. A good result can be expected.