"Nailing" the management of the ingrown great toenail.

"Nailing" the management of the severely ingrown great toenail, commonly encountered in the adolescent population, is an important tool in the pediatrician's armamentarium. I have found great toenail removal to be worthwhile, with straightforward indications; and quite rewarding for my patients in terms of time, convenience, and costs. The key to the procedure is to keep it simple. Four basic vital steps are involved: (1) operative permit and explanation; (2) performing a careful complete digital nerve block; (3) removing the entire toenail; and, importantly, (4) performing a partial chemical matricectomy--with readily available silver nitrate sticks--to prevent frequent recurrences.