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Painful to walk with small toe fracture,coagulated blood.

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I was recently admitted to the ER for a crush injury to my big toe on my right foot. I was told that I had a very small fracture and popped blood vessels under the nail, but that it wasn't bad enough to have to remove the nail or drill a hole to take out the blood. I was told to elevate my foot, ice the toe, take Tylenol as needed, keep it buddy wrapped to my second toe, and wear a hospital shoe until it was comfortable to wear a normal shoe again. It has now been a week and the blood has coagulated. From what I've read, the blood should naturally filter itself out. However, 3 days ago, the same toe was kicked from the front. Unsurprisingly, the toe was more painful to walk on than before, but what concerned me was that at the right base of the toe nail, there is a small, raised red bump under the skin that is very painful when pressure is applied. I'm hesitant to go to another hospital to have it looked at because it's only been a few days and I genuinely don't know if the bump was present at the time of the hospital visit or if it appeared after the toe was kicked. Is it possible that something happened to the base of the nail from the kick? Will my toenail fall off? What is this painful bump? (Note: the skin in the photo is imprinted from the wrapping, there is nothing wrong with the skin.)

Category: General Surgeon

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Category: Pediatric Surgeon
 20 Doctors Online

Hello.
Thank you for posting your query at DoctorSpring.com
I saw the picture.
Due to first injury,Haematoma (Collected blood )is seen beneath the nail.It may resolve spontaneously or may persist.
As you said,there is darker area near the base of the nail.It is due to 2nd trauma over clotted area.The darkness is due to fresh bleed.It got clotted again.The nail may not fall off its own.
I prefer to remove the nail completely and evacuate the blood and wait for new Nail formation.
There is nothing to worry, once the nail is removed it will heal faster.
Please consult your Surgeon and proceed.
Wish you good health.
Feel free to discuss further,
Regards.


Patient replied :

I've already been told by the hospital that removing the nail is not necessary. I'm more concerned about the root of the nail on this right side. In the photo, it looks as though there is an indent on the right side of my toe, which is actually a bump. The nail itself is no longer painful, but the bump (presumably the root of the toenail) is raised and is very painful. Am I correct in assuming this is the root of the nail? And if so, does its being raised indicate that the nail will not grow in normally?


Hello,
Usually, nail grows regularly and so we cut the edge of the nail if it is protruding.
The raised portion is Lunula .Regarding the growth of the nail ,it cannot be predicted now.You have to wait for couple of weeks.
Hope it won't affect the growth of the nail.
Hope I answered your query.
Feel free to discuss further,
Regards.


Dr. Hari Charan Perigela
Category: Pediatric Surgeon
Experience: 
Fellowship: DNB, General Surgery, National Board of Examinations, New Delhi, 2001
Residency: MS, General Surgery, Sri Venkateswara Medical College,Tirupathi, 2000
Medical School: MBBS, Kurnool Medical college, 1995
Dr. Hari Charan Perigela and 4 other Medical Specialists are ready to help you

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