Treatment for damaged nails and subnungual hematoma

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Following a severe blow or small repeated traumas, you may end up with damaged toenails or even a subungual hematoma. In the latter case, the nail turns blue because blood accumulates under the nail due to the impact. While the area is usually painless, it can sometimes—on the contrary—be quite sensitive.

Although they aren’t always painful, damaged nails should be treated, because they can get infected; indeed, by losing the completeness of its cuticles, the broken toenail is more vulnerable to fungal and bacterial infections. Furthermore, a totally or partially lost nail can remain detached or grow back ingrown. A trauma to the toenail can also result in working the skin under the nail and damaging the root; the deformed nail may then grow back permanently.

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According to the degree of severity of the nail hematoma, the podiatrist will offer the most appropriate treatment. If the accumulation of blood causes pain or raises the nail, they usually drain the subungual hematoma, clean the residue, and apply a sterile bandage. This operation is performed under local anaesthesia if necessary. The podiatrist can also take an X-ray of the toes if they suspect a fracture under the damaged toenails. In the most severe cases of subungual hematoma, they may need to completely remove the nail under anaesthesia.

Besides prescribing appropriate nail treatments for damaged nails, the podiatrist gives the patient recommendations to reduce the incidence of damaged nails, as this type of accident is by definition unpredictable. The most common recommendations regularly include cutting the toenails (but not too short) and wearing shoes that are the right size and suited to the activities practised.

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