MNT Orthotic Devices and Nail Bracing 2 — Questions and Answers
Question 1: The Onyfix nail correction system works by:
- Filing the nail to change its shape
- Applying a composite compound along the nail surface that hardens and uses the nail's own growth to correct curvature (Correct answer)
- Inserting a steel wire under the nail plate
- Chemically destroying the lateral matrix
Correct answer: Applying a composite compound along the nail surface that hardens and uses the nail's own growth to correct curvature
Onyfix uses a UV-cured composite applied across the nail; as the nail grows, the brace's spring tension progressively flattens the nail curvature without invasive procedures.
Question 2: How often are most nail braces replaced or adjusted?
- Every 24 hours
- Every 4–8 weeks, coinciding with nail growth (Correct answer)
- Once per year
- Only when they fall off naturally
Correct answer: Every 4–8 weeks, coinciding with nail growth
Nail brace treatment cycles of 4–8 weeks align with toenail growth; regular re-assessment allows the clinician to evaluate correction progress and adjust tension.
Question 3: A custom-molded silicone orthosis for a clawed toe is designed to:
- Prevent nail growth on the dorsal surface
- Provide cushioning for the tip of the toe and/or dorsal surface, preventing pressure ulceration (Correct answer)
- Stretch the extensor tendons
- Absorb sweat to prevent fungal growth
Correct answer: Provide cushioning for the tip of the toe and/or dorsal surface, preventing pressure ulceration
Clawed toes develop high-pressure points at the tip and dorsum; custom silicone orthoses protect these vulnerable areas from shoe friction and pressure.
Question 4: When applying a wire brace (e.g., VHO Goldstadt), the wire is anchored by:
- Suturing through the nail plate
- Hooking into small notches or holes filed/drilled at the lateral nail edges (Correct answer)
- Gluing along the proximal nail fold
- Inserting the wire beneath the nail bed
Correct answer: Hooking into small notches or holes filed/drilled at the lateral nail edges
Wire braces anchor at the lateral nail edges via notches or holes; tension in the wire creates an outward spring force that corrects nail curvature.
Question 5: Patient education after nail brace placement should include:
- Soaking the foot daily to keep the brace moist
- Keeping the brace dry, avoiding swimming and prolonged water immersion, and returning if brace loosens (Correct answer)
- Using nail polish over the brace to protect it
- Trimming the brace weekly with nail scissors
Correct answer: Keeping the brace dry, avoiding swimming and prolonged water immersion, and returning if brace loosens
Water immersion weakens adhesive bonding; patients should be instructed to keep braces dry and report early loosening to prevent loss of corrective tension.
Question 6: Plantar fascitis management with orthotics primarily aims to:
- Strengthen the plantar fascia through resistance
- Provide medial arch support and heel cushioning to reduce tension on the plantar fascia insertion (Correct answer)
- Immobilize the foot completely
- Elevate the metatarsal heads
Correct answer: Provide medial arch support and heel cushioning to reduce tension on the plantar fascia insertion
Orthotics for plantar fasciitis support the medial arch to prevent excessive pronation and provide heel cushioning, reducing the mechanical strain at the calcaneal fascia attachment.
MNT Orthotic Devices and Nail Bracing 2
The Onyfix nail correction system works by: