The Danish guidelines for the treatment of ingrown toenails

In Denmark, the Danish Regions hold the prime responsibility for our health care system - they run the hospitals and the general practitioner system.

In the official Danish “Doctor’s handbook” published by the Danish Regions, they recommend foot therapeutic treatment before surgery not once or twice, but 6 times on the page that lay out the recommendations for the professional treatment of ingrown toenails.

Here’s a translation of the recommendations:

When should the patient be referred?

  • The condition can usually be treated without surgery
  • Foot therapeutic treatment gives the best results and is recommended before surgery
  • If persistent symptoms despite foot therapeutic treatment, surgery may be indicated

General information about treatment

  • Generally foot therapeutic treatment is recommended. Surgery is only exceptionally indicated

Surgical treatment:
Chronic big toe Paronychia

  • Foot therapeutic approaches as described earlier should be tested before surgery

Patient Information:
What information should you give the patient?

  • Foot therapeutic approaches should be tried before surgery

In Denmark a foot therapist has, among many other things, an education in how to plan, evaluate, manufacture and treat ingrown toenail with different types of braces - Copenhagen school of foot therapist (Download pdf-file - in Danish)


International studies

Partial matrix excision or orthonyxia for ingrowing toenails
Quotation: “… performing activities of daily living and hobbies; postoperative symptoms; and patient satisfaction all favored orthonyxia.” (aka nail bracing)

Treatment of Unguis Incarnatus using the VHO-Osthold-Brace®perfect - an alternative to the Emmert Plastic?
Quotation: “… the “VHO-Osthold-Brace®perfect” provides a less painful, conservative method for the treatment of Unguis Incarnatus with a relatively low recurrence rate. The patients are less inhibited in their everyday life and hardly lose any working day.”

Efficacy of nail brace treatment for ingrown nails
Quotation: "98.6% of patients having ingrown nail (72/73) benefited from brace treatment" - "Conclusion: Nail brace application has been found effective for pain relief and as treatment in patients with ingrown nails and no statistically significant predictive factor has been found in terms of recurrence after treatment."

Treatment of symptomatic incurved toenail with a new device
Quotation: “All ingrown toenails healed and the nail deformity was corrected within 3 weeks after the procedure.”




Grünewald, Klaus (2007),
Theorie der medizinischen Fußbehandlung 2: Ein Fachbuch für Podologie, vol. 2,
München, Verlag Neuer Merkur GmbH, page 47ff.

Ruck, Hellmut (2005),
Handbuch für die medizinische Fusspflege: Grundlagen und Praxis der Podologie,
Stuttgart, Hippokrates Verlag in MVS Medizinerverlag Stuttgart GmbH & Co, page 201ff.

Feindt, Sybille (2007),
Handbuch der podologischen Behandlungsmethoden,
München, Verlag Neuer Merkur GmbH, page 56ff.

Scholz, Norbert (2005),
Extremfälle aus der podologischen Praxis,
München, Verlag Neuer Merkur GmbH, page 157ff.

Bittig, Fritz (2010),
Bildatlas der medizinischen Fußpflege,
Stuttgart, Hippokrates Verlag in MVS Medizinerverlag Stuttgart GmbH & Co, page 129ff.

You can read excerpt from the books on Google books.