Nail spicules are a rare but distressing sequela of improper toenail surgery. They are often extremely painful and refractory to conservative measures. We report two cases of nail spicules following improper or suboptimal surgery for an ingrown nail. Both patients presented with painful lateral nail fold swelling after surgical treatment for an ingrown nail at different centers. We treated both with spiculectomy combined with chemical matricectomy of the ectopic matrix. Only one of the four treated spicules recurred, which was again treated with the same procedure. Formation of a nail spicule is an unfortunate outcome of nail surgery, highlighting the importance of a proper knowledge of the nail anatomy and precise surgical technique. It is important to prevent spicule formation by attending to the lateral horns of the nail matrix. Management requires meticulous spiculectomy, matricectomy, and regular follow-up to ensure both functional correction and esthetic preservation.
Grover et al. (Mon,) studied this question.