Resolving ungual conflicts: orthonyxia or surgery

Orthonyxia methods, contraindications, advice… Doctor Julien Lopez accompanies you in resolving your ungual conflicts.
Without proper treatment, defects in the curvature or growth of the nail can cause inflammation of the periungual area, repeated ingrown nails and infections. Indeed, in these cases conflicts between the nail and the skin occur to the point of causing pain and discomfort. Orthonyxia is a method of placing an orthosis on the nail to exert tension to encourage normal nail growth.
Specialized in orthopedic pathologies most often occurring in athletes, the surgeon guides you towards the most suitable treatment for your ungual malformation. It is important to note that orthonyxies are podological solutions not performed by Dr.

Orthonyxia: price, definition and risk factors

Orthonyxia varies in price depending on the type of orthosis used and the specialist you choose to trust.
In fact, a pedicure-podiatrist and an orthopedic surgeon do not apply the same consultation rates and do not adhere to the same reimbursement schemes. All the information concerning the various costs as well as the percentage of reimbursement that you can benefit from will be communicated to you during your consultation.

Orthonyxia: definition

This orthopedic practice consists of placing an orthosis on the latter to allow a better growth. Its purpose is to solve a conflict between the nail of a toe and the surrounding skin. The normal growth of the nail is then encouraged by the fitting of an orthosis, which exerts a painless tension capable of accompanying a good growth of the nail. Thus, the ungual deformation is gradually resolved.
This orthosis can be composed of an alloy of titanium, nickel and chrome or fibreglass depending on the method chosen.
Some factors may be responsible for these growth and/or curvature defects. It is necessary to be aware of this in order to avoid potential recurrences.

Factors aggravating poor growth/ungual curvature

Some factors can worsen bad growth or abnormal curvature of your nails, which is the cause of infections and painful discomfort.
Here are some practices that can encourage conflicts between your toenails and your skin:

When is it necessary to proceed with orthonyxia?

Performed by podiatrists using different types of orthotics, this practice involves modifying the curvature or growth of a nail considered abnormal and in conflict with the skin. If it becomes particularly painful when the nail begins to produce periungual horns or ingrown nails repeatedly, an orthonyxia pedicure may be necessary.
Some forms of nails considered as “hyper-curvatures” are at the root of these conflicts:

Orthonyxia: tariff, methods and duration

The practice of orthonyxia orthotics varies in price depending on the methods used, the degree of correction of your curvature/ungual growth and the specialist you consult.

Orthonyxia methods

Thick nail orthonyxy is the laying of orthotics to give your toenails a natural curvature and growth. In this way, they no longer create conflict with the skin.
The specialist of orthopedic pathologies is able to perform this type of non-surgical procedure through several methods. Indeed, the specialist will carefully analyze your nail structure in order to orient you towards the most suitable and sustainable solution for your needs.
To do this, it takes into account 3 factors: the length, the degree of flexibility of your nail and the intensity of curvature to correct. Based on this diagnosis, it directs you to a particular orthosis. The different types of orthonyxies have different rates that the podiatrist will share with you during your consultation.

Titanium Photopolymerization Orthonyxia

The first orthonyxia is achieved by titanium photopolymerization. It consists in attaching titanium wire with memory of shape on the surface of the nail by means of resin studs located at its ends. The composition of the titanium makes that the traction is constant and without any pain. This technique allows progressive correction so that your nail regains a normal curvature.
The diameter of the titanium wires, their positioning and the importance of their fixation are elements that are reflected by the specialist in order to reach the curvature corresponding to your initial ungual morphology.
Nails with mycosis are brittle and therefore cannot be treated with titanium orthonyxia.
It is a durable method due to the "shape memory" property of the material used, it proves to be a lasting solution. Visible, it can cause discomfort in patients. It is nevertheless possible to hide the device with a false nail (onychoplasthie) or to remove it for a short time.

Orthonyxia with hooks

This orthonyxia method consists of using an alloy between nickel and chromium. Placed as close as possible to the nail matrix, it is held by hooks placed at each end of the nail which has abnormal curvature or growth.
The main advantage of this method is that it is adaptable. Depending on the desired tensile force and the sides to be corrected, the foot pathology specialist may decide to use the hook clips as part of the orthonyxia.
It is not recommended for diabetics because of the risk of injury caused by the proximity of the hooks to the groove. Titanium is most often preferred for these patients.

Orthonyxia with B-S (or laminate)

This orthonyxia method consists of placing a slide made of glass fibres or epoxy resin on the visible side of the nail of the toe. It is fixed by photo-polymerizable or cyanoacrylate specialized glue. No staples or attachments are made, which prevents any trauma that may occur in the ungulate grooves. However, unlike titanium light curing, the power and extent of the correction is difficult to measure.
In this sense, titanium light curing is the method most used by specialists to correct a bad growth or curvature of the nail.

Duration of orthonyxia treatment

The duration of orthonyxia is about 6 months, depending on the time required for the complete regrowth of the patient’s nail plaque. Regular follow-up is carried out by the podiatrist throughout this period in order to analyse the progress of the treatment. Photographs are taken to observe improvements.

Orthonyxia with a foot specialist

In case of orthonyxia installation and failure, the foot specialist Dr Julien Lopez can assess the effectiveness of the treatment and the level of residual discomfort. He asks you questions and makes a precise diagnosis in order to guide you towards the method best suited to your daily life and able to bring you lasting results.
Orthonyxia is a podological treatment that is not recommended for nails with mycosis. It is also not recommended for people practicing sports activities involving intense and important toes such as ballet or football. Indeed, in these cases the risks of orthonyxia failing are more important.
In addition, this treatment is sometimes not suitable or insufficient to correct a bad curvature or grows toenails in conflict with the skin. These malformations cause ingrown nails and repeated inflammations.
The orthopedic surgeon then directs you to other solutions, such as a non-invasive surgical procedure, to correct this repeatedly occurring discomfort.