Total Nail Avulsion

Comprehensive Overview of  Total Nail Avulsion (TNA) Procedure: Indications and Benefits

A total nail avulsion (TNA) procedure involves the safe removal of the entire toenail. This procedure is indicated in a variety of circumstances, such as cases of ingrown toenails where both sides recurrently ingrown and there is a large curvature at the sides of the nail. Here, instead of removing two larger sides of the painful nail, a patient will opt to simply have the entire nail removed so it can grow back as a normal, straight nail – or not grow back at all depending on the method they choose.

Aside from ingrowing or involuting (high degree of curvature) nails, this procedure is also used as a solution for disfigured, thickened, infected and damaged toenails where the nail itself is causing ongoing pain or great discomfort, especially when wearing shoes and performing daily activities.

The benefits of a TNA include:

1. The procedure is done simply in-clinic
2. The total appointment time typically doesn’t exceed 60 minutes (with the procedure time typically around 20 minutes)
3. The procedure is performed under local anaesthetic so is pain-free
4. You do not need to take any additional time off work/school following the procedure and can go home immediately
5. You do not need any special boots or braces while the toe heals
6. The procedure causes little post-procedure discomfort, however painkillers can be taken should discomfort arise
7. We dress your toe, provide you with a take-home dressing pack and re-dressing instructions
8. We monitor your progress to ensure it is healing well

The Procedure

This procedure is very similar to the PNA, but instead removes the entire nail.

1. We first inject the toe with a common local anaesthetic using the thinnest needle possible for your comfort
2. When the area is numb, we will perform the procedure in which the nail will be detached and pulled out
3. If you already have an infection, it will be surgically drained and any overgrown tissue is cut away
4. Where a chemical matrixectomy is part of the procedure, we apply the chemical (phenol) to the exposed nail base (where the nail growing cells are located), before flushing it away and neutralising the area
5. We dress the toe with a number of dressing materials for optimal healing

Recovery time is anywhere from two weeks to two months barring any complications such as infection. We provide you with all the dressings, topical antibacterial solutions and ointments, the post-op shoe and aftercare instructions, all tailored individually to your needs.

Unsure which procedure is best for you?

Don’t worry – that’s exactly why we’re here. Because ingrown toenails can start from something as simple as your footwear choice for one day, they are unfortunately very common. This is our area of expertise and we see a variety of ingrown toenails every day, from full-blown infected swollen toes to small ingrown nails that don’t appear “bad” but are still quite painful and will only worsen as the nail continues to grow.

We start each appointment by assessing the toenail and discussing the likely cause of the problem. We’ll then be able to go through each procedure and their outcomes, and give you all the information you need to help you make the best choice and get the best results for your feet. After you leave your appointment, if you have any questions, our team is available to speak to during business hours and can also reply by email. We always put your health and well-being first and are here to help you in any way we can!