teamCSSM - Camberwell Sports and Spinal Medicine
What is an in-grown nail?
An in-grown nail pierces (or is uncomfortably presses against) the adjacent skin of the toe causing pain and inflammation and sometimes infection. Nail surgery is recommended for patients with recurrent painful or infected in-grown nails.
Nail surgery known as partial nail avulsion (PNA) is recommended by a podiatrist when this continues to be a problem causing discomfort from footwear and the condition affects work, school and sporting activities.
How is the procedure performed?
The procedure is performed under local anaesthetic with two injections into the top of the affected toe. The needle is small and only a small volume of local anaesthetic is required to anesthetise the toe. The anaesthetic takes a few minutes to numb pain in the toe. For a short period, a patient will still be able to feel touch but not pain in the local area.
The toe requiring the PNA is cleansed with betadine surgical solution and a rubber ring is placed over the toe to temporarily restrict blood flow. A small portion of nail is removed from the affected side of the toe. Usually this portion is so small that cosmetically it is unnoticeable to most people.
Will the nail grow back?
Importantly, a chemical is applied to the growth area to prevent the nail regrowing in this section. This is successful in 99% of cases. Once the chemical is applied it is then flushed out with more betadine surgical solution and the rubber ring is removed restoring normal blood flow to the toe. Sterile dressings are then applied which should be kept dry for a few days. Patients can walk immediately following the procedure but we recommend having someone drive you home.
Do I need a follow-up appointment?
Your podiatrist will discuss with you the need for follow-up appointments. This varies depending on age, medication taken and other factors. Initially an appointment will be made to remove the dressings and clean the area well before a smaller dressing is applied. In some instances your podiatrist will direct you to change dressings at home.
Most people manage pain relief after the procedure with paracetamol. Aspirin should be avoided for at least 48 hours as it may make the wound bleed. Patients should be able to return to work or school the following day. Initially some patients are unable to wear their regular footwear while the bulky dressing is on.
All surgical procedures carry risks, however the risk of complication following PNA is very low. Please discuss with your podiatrist if you have any questions.
Please call CSSM if you think you may need to have a PNA.
How much does the procedure cost?
The initial cost of this procedure is $350 which includes removal of a single edge, phenol sterilisation of the affected nail matrix and two follow up appointments to check the status of the nail. If edges on other affected toes are suggested by your Podiatrist to be removed, they can be done on the same day for $90 for each additional edge. It is quite common that the other edge on the same toe requires removal.
This procedure is claimable under Podiatry with your Private Health Insurer, DVA or TAC depending on the level of your cover.
Persons of any age and ability can benefit from a gait analysis. We assess all individuals, whether that be in regards to a particular sport at the elite level or for the weekend warrior. In particular gait assessment is useful if:
The wealth of information garnered from your assessment can be used in many ways. Advice may range from simple changes in footwear or technique right through to an in depth breakdown of your technique to introduce significant biomechanical changes. Mostly advice centres around recommendations of specific exercises or a program of exercises to address deficiencies. In some cases these assessments help confirm treatment paths such as orthotic prescription as viable options.
Our Running Gait Assessments are generally performed by our Podiatry team, with input from our Physiotherapy and Osteopathy team.
Appointments can be made by calling the clinic on 9889 1078.
Alternatively appointments can be requested via our online portal at our website www.cssm.com.au
The running gait analysis involves 2 appointments usually a week apart.
For the full assessment and gait analysis, this takes between 1-1.5 hours for the first appointment. A follow up appointment is then scheduled to go through your results in detail with you. This follow up appointment usually takes 30 minutes.
Shorts or leggings are best to allow us to perform relevant assessments, and for us to be able to clearly see and analyse
your running technique.
Please bring in runners (old and new), as well as any other shoes you may use for different sports (e.g. football boots, netball shoes etc.). Please feel free to bring along any other shoes that you feel may be relevant to your assessment.
Not at all. Whilst we receive a lot of referrals from running coaches, personal trainers GP’s and other health professionals for this service. A referral is not necessary, if you feel that you have a running related injury – give us a call. .
The initial gait analysis package including both before and after consultations and all take home material is $255.
If you have private health insurance these services will qualify for a rebate under your ancillary or extra’s cover. The rebate varies depending on your health insurer and level of cover so check the details of your policy.
Running Gait Analysis sessions are generally conducted for the management of running injury and pain. Therefore these sessions are covered under your podiatry allocation within your private health insurance. Please contact your health insurer to determine your eligibility and level of cover.