A novel matrix-preserving technique (QS-PFE) versus the winograd procedure for Heifetz stage 3 hallux onychocryptosis in adolescents: A retrospective comparative study.

BACKGROUND: Onychocryptosis is common in adolescents. We compared clinical outcomes, recurrence, and satisfaction of a matrix-preserving technique with the Winograd procedure. METHODS: This retrospective study included 325 consecutive adolescents with Heifetz Stage 3 onychocryptosis. Group 1 (n = 127) underwent quadrangular suturing of the nail bed with partial nail-fold excision without matricectomy (QS-PFE); Group 2 (n = 198) underwent the Winograd procedure. Primary outcomes were postoperative VAS pain, recurrence, and nail-width preservation. RESULTS: Both groups were comparable preoperatively (all p > 0.05). First-week pain was modestly higher with QS-PFE (5.9 vs. 4.0) but became significantly lower at 3 and 6 months (0.4 vs. 1.4; 0.1 vs. 0.7; both p < 0.001). QS-PFE patients resumed school and sports sooner. Recurrence was markedly reduced (0.8% vs. 15.2%; p < 0.001), with higher satisfaction (96.1% vs. 67.7%). CONCLUSION: QS-PFE may be a promising matrix-preserving alternative to the Winograd procedure, with lower recurrence and higher satisfaction in this series. Prospective randomised studies are warranted.