Nail … when to cut?

A 22 year man , with history of trauma to his left toe two months ago. it has been painful ever since and pain is increasing, somtimes with discharge coming out but no fever. he doesnt wear tight shoes and was prescribed miconazole crem which only helped a little.

on examination left big toe is tender and the lateral nail folds are swollen and erythematous. the lateral nail edges cant be seen.

between the lateral nail folds and the nail the patient has some granulation tissue. other toes are normal

to me this looks like ingrown nail, and i believe he needs Partial nail removal  performed by clipping distal corner or by removal of the entire lateral portion of the nail. my questions are:

does he need matrictomy? since this was preciptated by trauma and he has never complained before that?

and for preventive purposes , will cotton balls be enough to to stop them from recurring?

thanks!

2 Responses

  1. i think cautersiation is necessary at this stage after the lateral nail is removed. and the nail is grossly swollen, i would culture any discharge too…and trea accodrdingly, but the most important thing is teach the patient how to cut te nail properly..

  2. To prevent recurrence wedge excision include the matrix of the affected site

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