1) Study of the Cause of Ingrown Toenail Ingrown toenail occurs when the tissue of lateral nail fold is pushed up from the ground side, and the toenail plate consequently grows into the tissue of lateral nail fold. A major cause of ingrown toenail is increased pressure on the first toe, which is the toe most frequently affected by this disease. This pressure increase is caused by dysfunction of the foot, deformation of the foot and other disorders. A dysfunction of the foot frequently observed in ingrown toenail patients is reduced dorsal flexion angle of the ankle joint and the first metacarpophanangeal joint (hitherto referred to as 1st MTP joint). Reduced dorsal flexion angle of the ankle joint deflects the center of gravity of the body weight bearing on the sole towards the first toe during walking. Reduced dorsal flexion angle of the first MTP joint leads to increased pressure load on the first toe during rising from the bed. Diseases that cause foot deformation include spread foot, calcaneus valgus, pollex valgus and unequal leg lengths. These abnormalities lead to outward abduction of the first toe and reduced dorsal flexion angle of the first MTP joint. Inequality of leg lengths leads to increased pressure load on the shorter leg.
2) Study of the Efficacy of the VHO Regimen We applied the VHO (Virtuous Human Orthonyxie) regimen (hereafter referred to as the regimen), one of the non-invasive therapies for ingrown toenai (1,2), to 61 cases of this disorder. The patients consisted of 11 men and 50 women, their ages ranged from 13 to 76 year (means age : 41.1 years). Of the 54 cases in whom the clinical course was evident, early disappearance of pain was achieved in 38 cases (70.3%). However, 6 patients needed subsequent operations. Our study showed that this regimen is a non-operative therapy with little invasiveness and is particularly effective for cases with mild symptoms.
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