Opioid Prescribing Patterns Associated with Selective Matrixectomies for Toenail Onychocryptosis: A TriNetX Analysis
Abstract
Introduction: Selective matrixectomy is a common intervention for painful onychocryptosis that is associated with mild-to-moderate postoperative pain. It can usually be managed effectively with non-opioid analgesics. We evaluated rates and factors associated with opioid prescribing following selective matrixectomy to guide physicians in counseling postoperative patients.
Methods: A retrospective cohort study was conducted using the TriNetX research network, querying for patients who underwent selective matrixectomy for onychocryptosis. Opioid prescriptions <3 days after selective matrixectomy were assessed, and Cox regression estimated hazard ratios and 95% confidence intervals for opioid prescribing, adjusting for factors associated with prolonged opioid use.
Results: Among 97,208 patients who underwent selective matrixectomy, 14,759 received an opioid prescription <3 days postoperatively (15.2%), declining from 24.3% during 2008-2018 to 12.8% during 2018-2025. Female sex, older age, Asian race, antidepressant use, and histories of anxiety, depression, chronic pain, migraine, osteoarthritis, and back pain were associated with lower likelihood of opioid prescribing. Black/African American race, Hispanic/Latino ethnicity, prior benzodiazepine or opioid use, and fibromyalgia were associated with higher likelihood.
Conclusion: Opioid prescribing following selective matrixectomy was relatively common and may be more frequent than clinically necessary. Prescribing patterns appear…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 97,208 participants or records.
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