Orthonyxia as a Noninvasive Treatment for Ingrown Toenails in Pediatric Patients: A Retrospective Study

BACKGROUND/OBJECTIVES: Ingrown toenail is a painful condition characterized by penetration of the nail plate into the periungual soft tissue. Surgical treatment may provoke stress and delay recovery, increasing interest in noninvasive alternatives. This study aimed to evaluate the clinical outcomes of orthonyxia techniques in children with ingrown toenails and to identify factors associated with healing duration. METHODS: This retrospective study included 31 pediatric patients treated with orthonyxia between January 2022 and October 2024. Patients were evaluated clinically and classified according to the Heifetz staging system. Adhesive and wire-based orthonyxia techniques were applied based on clinical presentation. Treatment outcome was defined as complete clinical remission. Logistic regression was used as an exploratory analysis for delayed healing (> 3 months), and multiple linear regression was performed to identify independent predictors of healing duration. RESULTS: The mean age was 14.0 ± 1.9 years, and 71.0% of patients were male. Nearly half of patients presented with Heifetz stage III disease. The mean healing duration was 3.3 ± 2.6 months. Complete remission occurred within ≤ 3 months in 64.5% of patients. Tampon application was associated with faster healing, whereas 3TO brace and silver nitrate applications were associated with delayed healing. Multiple linear regression identified female sex, younger age, higher body weight, and 3TO brace application as independent predictors of prolonged healing duration. CONCLUSIONS: Orthonyxia is an effective treatment option for pediatric ingrown toenails. Its practical value in children includes avoidance of surgery and immediate return to daily activities.