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Trimming toenails can be performed in a number of ways that include straight across or deep down into the corners. Most important is the need to effectively trim the entire nail, not leaving any of the remaining nail in place to subsequently cause an ingrown nail.
Improper trimming of the nail can result in a number of foot problems, first and foremost being ingrown nails. Most ingrown nails (paronychia) result from partial or incomplete trimming of the nail. A common mistake is to trim the nail to the corner and tear the nail away. Tearing the nail often leaves a small spike of nail along the outer margin of the nail. Slowly, the nail continues to grow and push the spike forward. The spike begins to act like a foreign object, just like a splinter. As the nail grows, the splinter becomes increasingly embedded in the skin, resulting in an infection. Surgical correction of an ingrown nail is usually a matter of removing the little spike that's causing both pain and a foreign body reaction (infection.)
Who gets ingrown nails and why? You have to wonder why the most common ingrown nail patients are teenage boys and pregnant women. Teenage boys aren't particularly concerned about hygiene. They're also prone to more trauma to the nail from sports. Pregnant woman find that with each month of their pregnancy, their arms get shorter and their legs get longer, resulting in an inability to care for their feet.
The key to successful nail trimming is to be sure you trim the nail regularly and completely. Use a nail cutter with a curved, pointed tip. Be sure to round the edges using a double ended nail file, checking for the little spikes at the edge of the nail. Smooth the edges of the nail to prevent the nail from catching on hose or socks. The rate of growth of the toe nail is very slow, therefore trimming once every 4-6 weeks should be sufficient to keep nails well-trimmed and healthy. When trimming the nails, take the opportunity to check between the toes for fungal infections. Fungal infections of the skin will slowly infect the nail, resulting in toe nail fungus.
Causes and contributing factors
Additional contributing factors to ingrown nails include a tight toe box on the shoe, trauma to the nail, and diseases of the nail.
Treatment Guidelines - patient guidelines for treatment of toe nail fungus.
ICDM-10 Codes - Toe nailsB35.1 Toe nail fungus
L03.031 Cellulitis of right toe
L03.032 Cellulitis of left toe
L03.039 Cellulitis of unspecified toe
L60.0 Ingrown toenail
CPT codes - Toe nail trimming11719 Trimming of nondystrophic nails, any number
11720 Debridement of nail(s) by any method(s); 1 to 5
11721 Debridement of nail(s) by any method(s); 6 or more
11730 Avulsion of nail plate, partial or complete, simple; single
11732 Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedure)
11740 Evacuation of subungual hematoma
11750 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal
11752 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal; with amputation of tuft of distal phalanx
11755 Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)
11760 Repair of nail bed
11765 Wedge excision of skin of nail fold (eg, for ingrown toenail)
Current Procedural Terminology (CPT®) is a product of the American Medical Association (AMA).
Author(s) and date
This article was written by Myfootshop.com medical director Jeffrey A. Oster, DPM.
Cite this article as: Oster, Jeffrey. Toe Nail Trimming. http://www.myfootshop.com/article/toe-nail-trimming
Most recent article update: July 11, 2019.
Toe Nail Trimming by Myfootshop.com is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License.