Stage-4 Ingrown Toenail—6 Months Later

Six months status-post total matricectomy. Onychocryptosis (ingrown toenail) is an inflammatory condition in which the body perceives the nail as a foreign object. I advance the staging system as follows:
Stage-1 Minor cryptosis that will likely resolve without invasive procedure (i.e., conservative management only).
Stage-2 Moderate cryptosis requiring minimally invasive treatment; (e.g., “Bevel Nail Resection,” which does not require matricectomy).
Stage-3 Advanced cryptosis that does require a partial matricectomy. This stage also includes the “Vandenbos Procedure” (i.e., surgical excision of the perionychium and distal fleshy overgrowth, which frees the nail and preserves cosmetics).
Stage-4 Advanced cryptosis which requires a complete matricectomy. I urge the least invasive procedure that will resolve ingrown toenail; sometimes however, for a variety of reasons, no reasonable options remain other than removing the nail permanently.