Minimal Matricectomy Combined with Lateral Longitudinal Excision Versus Total Nail Avulsion for Ingrown Toenail: A Two-Center Retrospective Cohort Study with Propensity Score Analysis

Background and Objectives: Ingrown toenail frequently causes pain and infection and may recur following surgical treatment. This study compared a nail-preserving strategy, minimal matricectomy combined with lateral longitudinal excision, against total nail avulsion for recurrence and clinical outcomes, using propensity-score analysis to address non-randomized treatment allocation. Materials and Methods: In this two-center retrospective cohort study, 412 patients treated between January 2020 and December 2024 were classified according to the surgical procedure received: minimal matricectomy with lateral longitudinal excision (n = 233) or total nail avulsion (n = 179). The primary endpoint was recurrence; secondary outcomes included postoperative pain, healing time, infection, reintervention, return to activity, and patient satisfaction. Inverse probability of treatment weighting (IPTW) was used as a sensitivity analysis, and recurrence-free survival was assessed using the Kaplan–Meier method with the log-rank test.