{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:47:25Z","timestamp":1782492445723,"version":"3.54.5"},"reference-count":5,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Skin Appendage Disord"],"abstract":"<jats:p>Introduction: Onychogryphosis has been associated with chronic foot injury and vascular disease. We evaluated whether onychogryphosis is associated with increased 5-year risk of lower extremity complications. Methods: Using TriNetX Research Network patients with onychogryphosis were propensity score matched 1:1 to controls for age, sex, race, obesity, type II diabetes, chronic kidney disease, and smoking. Cox proportional hazards models estimated 5-year hazard ratios (HRs) for lower extremity complications, with subgroup analyses for diabetes and peripheral artery disease (PAD). Results: After matching (174,537 per cohort), onychogryphosis was associated with increased 5-year risk of foot\/toe amputation procedures (HR 2.798, 95% CI: 2.516\u20133.111), ulcer (HR 2.108, 95% CI: 2.023\u20132.196), cellulitis (HR 1.743, 95% CI: 1.685\u20131.803), osteomyelitis (HR 1.673, 95% CI: 1.583\u20131.769), and gangrene (HR 1.485, 95% CI: 1.382\u20131.597) (all p &lt; 0.0001). Associations remained significant in diabetes and PAD restricted analyses. Conclusion: Onychogryphosis was associated with substantially increased 5-year risk of major lower extremity complications in a large matched cohort, with consistent findings among patients with type II diabetes and PAD. Identification of onychogryphosis should prompt focused lower extremity assessment and brief risk screening with a low threshold for vascular or primary care referral in high-risk patients.<\/jats:p>","DOI":"10.1159\/000551347","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:01:49Z","timestamp":1781625709000},"page":"1-4","source":"Crossref","is-referenced-by-count":0,"title":["Association between Onychogryphosis and Lower Extremity Complications: A Multicenter Cohort Study Using TriNetX"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4701-6452","authenticated-orcid":false,"given":"Natalia","family":"Chalupczak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5913-9304","authenticated-orcid":false,"given":"Shari R.","family":"Lipner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1159\/000485854"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1177\/1203475420928913"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000530096"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2022.2044511"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.3.382"}],"container-title":["Skin Appendage Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000551347","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:01:09Z","timestamp":1782489669000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000551347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":5,"URL":"https:\/\/doi.org\/10.1159\/000551347","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32684955","asserted-by":"subject"}]},"ISSN":["2296-9195","2296-9160"],"issn-type":[{"value":"2296-9195","type":"print"},{"value":"2296-9160","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]}}}