I Stubbed My Toenail and It Is Black and Hurts!

Stubbed toenails that result in discolouration are common injuries that may seem like no big deal.  Unfortunately, sometimes these can result in serious complications and often need medical management to prevent long term issues.  Toenails can become damaged easily, either from dropping something on the toe or from direct blunt pressure when stubbing the toe.  As a result of the injury, blood can pool under the nail, causing discolouration of a small part of the nail or even the entire nail.  Eventually, the nail can lift off the nail bed due to the pressure from the fluid under the nail and can lead to permanent damage to the fragile nail root cells resulting in a deformed nail.  One significant concern with this type of injury is the possibility of a fracture of the end bone of the toe causing the bleeding.  In this scenario, a piece of the bone sticks into the nail bed skin under the nail.  This is technically an open fracture and can lead to bone infection if not treated properly.

In cases where the entire nail is darkly discoloured after a stubbing injury and pain are present, it is typically recommended that the nail be removed and the fluid drained.  This has several important benefits.  Firstly, it reduces pressure off the toe to reduce pain while also helping to allow the nail root cells to be less damaged by the upward lift of that pressure on the nail from the fluid below.  It also reduces the risk of bacterial infection, as bacteria love to thrive in a trapped bloody fluid.  Finally, it permits inspection of the nail bed skin to ensure there are no bone fragments that could complicate the healing and lead to a difficult-to-treat bone infection.  This can be done in our office in a matter of minutes under a local anaesthetic, with near-immediate relief of most of the pain.

If you have stubbed your toe and the nail is discoloured and painful, be sure to see us as soon as possible.  We can fix the problem and reduce the chance of later complications!

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