We can all relate to the “ouch” feeling we get when we get a stubbed toe, and local Brandon Podiatrist Rajnish Manohar is here to help.
Often such injury leads to a bleed under the nail, a condition called subungual hematoma. These bleeds can result in dark discoloration (i.e., black nail), pressure and pain. In addition to being painful, nail discoloration can likewise be unsightly. This is another reason why many people seek medical help for this condition. If you experience this type of bleed, it’s an great idea to make a visit to the Gentle Foot Care Clinic for treatment.
Particularly, nail trephination, a treatment in which a hole is made in the nail to facilitate drain, can help. We will talk about that in just a bit.
What happens when you stub your toe?
With subungual hematoma, injury to the nail results in bleeding (hematoma) at the level of the nail bed (under the nail plate) or nail matrix. Of note, the nail matrix is a quickly dividing layer of cells at the base of the nail lying towards the cuticle. Quickly dividing cells of the nail matrix fill with keratin and therefore become solidified nail. More extensive damage to the nail can not only result in bleeding under the nail (i.e., simple subungual hematoma) however likewise more comprehensive damage to the nail fold or digit itself. If left untreated, a simple subungual hematoma generally grows out with the extending nail plate and deals with by itself. Of note, in some cases subungual hematomas can result in your nail falling off (i.e., onycholysis).
Up until the nail grows out, however, you can anticipate weeks to months of blue-black discoloration. Interestingly, fingernails grow faster than toenails so it takes longer for your toenails to grow out. Dr. Manohar treats the pressure and discomfort that can come with blood under the nail. Delayed treatment can result in nail defect or infection. Finally, with discomfort and serious injury secondary to subungual hematoma. In that case, you ought to likewise see an orthopedic doctor since there may be a toe or finger fracture.
Could the black nail be something else?
Dr. Manohar will examine your toe and take into account your medical history. The majority of cases of subungual hematoma can be easily identified and treated. When a fracture is suspected, an x-ray is needed. Rarely, what appears to be a subungual hematoma can be something else such as:
- Nail bed mole (a mole or birthmark that grows gradually or not at all).
- Splinter hemorrhage (a sign of psoriasis or endocarditis).
- Longitudinal melanonychia (pigmented bands).
- All these listed conditions are pain-free, and, unlike subungual hematomas, these sores don’t change or change gradually.
Since a few of these differential diagnoses are major, like endocarditis (i.e., heart infection) or melanoma (i.e, skin cancer), it’s a wonderful idea to have your nails had a looked at by Dr. Manohar when you see something suspicious. If a more major diagnoses is suspected, he may refer you to another specialist to see that your condition isn’t serious or life-threatening.
What can a Brandon Podiatrist do about your toenail?
It takes about two days for blood at the level of the nail bed to clot. During this time, this blood can be drained pipes by a doctor, a process called nail trephination. If you wait to have the blood drained pipes, nail trephination may not be able to be carried out. Throughout nail trephination, Dr. Manohar will use a hot metal wire, electrocautery gadget, or spinning, large-bore needle to pierce the nail bed. The hole created by piercing must be big enough to let the blood drain which takes about a day or more. Throughout this time, the hole through which the blood exudes should be covered with sterile gauze.
After nail trephination, you will not need prescription antibiotics although a pain reliever like ibuprofen might aid with recurring discomfort. Your doctor will recommend you on effective pain relief. After trephination, make certain to follow all your physician’s directions (consisting of directions to soak the afflicted location and apply clean dressing) and follow up with your physician as prescribed. You should call the Gentle Foot Care clinic right away if it appears that the affected area reaccumulates blood or ends up being contaminated. Despite nail trephination hurting, fortunately, the nail bed lacks innervation so nail trephination does not injured.
When the hematoma covers more than half the nail, your doctor might pick to remove the nail entirely. Additionally, if the nail injury is deep, the nail may also be removed, Prior to eliminating the nail, your physician will perform a digital block in order to anesthetize the location.
Brandon Podiatrist Rajnish Manohar can help
Your garden variety stubbed toe may not be serious, but it could develop into something more painful. It is best that you schedule an appointment right away if the pain is extreme or you notice any of the warning signs listed above. Dr. Manohar is available at his Brandon office by appointment by calling (813) 502-5904 or you can just walk in. If you would like to get in touch with the office via email, you can send one using this form on our website.
Dr. Manohar has been in private practice as a Podiatrist in Zephyrhills since 2001, treating Foot and Ankle Pain including Diabetic Foot Pain and Neuropathy, as well as, providing routine Diabetic Foot Care.
Dr. Manohar is board certified by the American Board of medical specialties in Podiatric Medicine. He is a member of the American Academy of Podiatric Sports Medicine. Dr. Manohar resides in Temple Terrace, Florida.
Dr. Manohar specializes in treating foot and ankle pain, Plantar Fasciitis and Heel spurs, Neuromas, Peripheral Neuropathy, Ingrown toenails, Non healing wounds, corns, calluses, Warts, Cysts, Toenail fungus.
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