Treatment Options for Deformed Toenails After Injury: A Guide - Surgery

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Deformed toenails following an injury can be a significant source of discomfort and pain, particularly when they affect walking and daily activities. In your husband's case, the trauma from the artillery shell that caused the toenail to fall off and subsequently grow back in a deformed manner can lead to various complications, including pain similar to that experienced in ingrown toenails (onychocryptosis) or nail bed infections.


Treatment Options for Deformed Toenails
1. Podiatric Evaluation: The first step is to consult a podiatrist or a healthcare professional specializing in foot care. They can assess the extent of the deformity and any underlying issues that may be contributing to the pain.

2. Nail Trimming and Care: Regular trimming of the toenail is essential. The nail should be cut straight across to prevent ingrowth. If the nail is thickened or deformed, a podiatrist can help with proper trimming techniques to alleviate pressure and pain.

3. Orthotic Devices: Custom orthotic devices or shoe inserts can help redistribute pressure away from the affected toe, providing relief during walking. Proper footwear that accommodates the deformed toenail is crucial. Shoes should have a wide toe box and be cushioned to minimize pressure on the toe.

4. Topical Treatments: If there are signs of infection or inflammation, topical antifungal or antibacterial treatments may be prescribed. Over-the-counter pain relief medications, such as acetaminophen or ibuprofen, can help manage pain and swelling.

5. Nail Surgery: In cases where the toenail is severely deformed and causing significant pain, surgical options may be considered. This could involve partial or complete nail avulsion (removal) to allow for proper healing and regrowth. In some cases, a procedure called matrixectomy may be performed, which involves removing the nail matrix to prevent the nail from growing back.

6. Physical Therapy: If the deformity is affecting gait or causing compensatory issues in other parts of the foot or body, physical therapy may be beneficial. A physical therapist can provide exercises to strengthen the foot and improve mobility.

7. Follow-Up Care: Regular follow-up appointments with a podiatrist are essential to monitor the condition of the toenail and surrounding tissues. This is particularly important if there are any changes in color, shape, or if pain persists.


Additional Considerations
- Infection Prevention: Keeping the toenail and surrounding area clean and dry is vital. If there are any signs of infection (redness, swelling, pus), prompt medical attention is necessary.


- Nutritional Support: A diet rich in vitamins and minerals, particularly biotin, zinc, and protein, can support nail health and growth.

- Avoiding Trauma: Protecting the toe from further injury is crucial. This may involve avoiding activities that put excessive pressure on the toe or using protective footwear.

In summary, the treatment of deformed toenails after an injury involves a combination of proper nail care, appropriate footwear, potential surgical intervention, and ongoing monitoring. Consulting with a healthcare professional is essential to tailor the treatment plan to your husband's specific needs and to ensure the best possible outcome.