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gree0411

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Hi, I'm a first year Emergency Medicine resident. I wanted to get some advice from a podiatrist. I was playing football the other day when I came to a hard stop and felt the nail of my first toe catch on the inside of my shoe. When I took my shoe off I realized that I had a subungual hematoma (it was painful too). The next day after no relief of pain I did a trephanation and drained off some fluid. I did the same thing the next day. Now I'm about 10 days out and I have this space under my nail. After I take a shower I squeeze a bunch of water out from underneath my toe. I'm just curious what the outlook is for my toe. Should I take the nail off or leave it for protection? I am mainly concerned with infection within the space. Let me know what you think. Thanks.
 

runnersfeet

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Just to be clear, I am not a Podiatrist and not even in Podiatric Medicine school - though I will be starting next year. However, I have seen a Podiatrist MANY times the last 5 years for TONS of foot injuries....one of which, sounds very similar to yours. So, although I cant answer with any true medical advice, I can just tell you what happened to me. I had the nail punctured so as to drain any fluid/blood under the nail - which helped a lot with the pain and swelling. After about 10 days, I lost the nail and about 2 months later it had grown back entirely - good as new! Hope the healing goes well with you too. I was specifically told to NOT remove the nail myself and to let it fall off when ready. I was also told to not further puncture the nail, but to allow it to drain through the hole that was punctured by the doc. hope this helps some:)

gree0411 said:
Hi, I'm a first year Emergency Medicine resident. I wanted to get some advice from a podiatrist. I was playing football the other day when I came to a hard stop and felt the nail of my first toe catch on the inside of my shoe. When I took my shoe off I realized that I had a subungual hematoma (it was painful too). The next day after no relief of pain I did a trephanation and drained off some fluid. I did the same thing the next day. Now I'm about 10 days out and I have this space under my nail. After I take a shower I squeeze a bunch of water out from underneath my toe. I'm just curious what the outlook is for my toe. Should I take the nail off or leave it for protection? I am mainly concerned with infection within the space. Let me know what you think. Thanks.
 

IlizaRob

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gree0411 said:
Hi, I'm a first year Emergency Medicine resident. I wanted to get some advice from a podiatrist. I was playing football the other day when I came to a hard stop and felt the nail of my first toe catch on the inside of my shoe. When I took my shoe off I realized that I had a subungual hematoma (it was painful too). The next day after no relief of pain I did a trephanation and drained off some fluid. I did the same thing the next day. Now I'm about 10 days out and I have this space under my nail. After I take a shower I squeeze a bunch of water out from underneath my toe. I'm just curious what the outlook is for my toe. Should I take the nail off or leave it for protection? I am mainly concerned with infection within the space. Let me know what you think. Thanks.
If you dont mind me asking, where in Iowa are you doing your residency?
 
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efs

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I'm a third year resident, and have done essentially the same thing myself.

Wouldn't recommend giving or recieving most medical advice via essentially anonymous forums, but this sounds pretty straightforward.

Nail is separated from the nail plate and at some point you will probably loose the nail. New nail is growing in as matrix has not been damaged. Usually about 9-12 months for a new nail to completely grow out, so it may be some time before the nail is back to it's former self. In the mean time I would leave it on for some protection of the underlying nail bed. As it grows out you may trim it back, at some point it will become loose enough you'll probably feel pretty comfortable in removing the remaining portion.

Should not be any long term damage done, it'll just take time.
 

gree0411

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Thanks for the info guys. I knew I could count on my Podiatry brothers.

I'm actually now in Pennsylvania at Penn St. for residency. I went to med school at Des Moines University.
 
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