Toenail Issues: When to See a Specialist for Pain and Deformity

Issues with toenails and bones?

Hello, Doctor.
I have been experiencing a problem with my toenail (big toe) for some time, which I initially thought was a fungal infection like onychomycosis.
Since it hasn't been painful often, I didn't pay much attention to it.
Recently, I noticed that the toenail has been growing upwards, and the angle from the side view is becoming steeper.
It feels like the underlying bone is deforming and pushing the nail upwards, causing issues like onychogryphosis.
Which specialty should I consult for this issue? Should I see a general surgeon, an orthopedic surgeon, or a plastic surgeon?

chin, 30~39 year old female. Ask Date: 2017/12/02

Dr. Ye Qianyu reply Family Medicine

Hello! Suitable specialties include dermatology, orthopedics, general surgery, and plastic surgery.
The handling of your case is related to the patient population of the physician.
It is recommended that you first visit the dermatology department at a local or regional hospital, and if it's not appropriate, the physician can refer you to another specialist.
Thank you for your inquiry!

Reply Date: 2017/12/02

More Info

When it comes to toenail issues, particularly concerning conditions like "frozen toenails" (which I assume refers to a condition where the toenail is deformed and possibly painful), it is essential to understand the underlying causes and when to seek specialized medical attention. Based on your description, it seems that you are experiencing a deformity in your toenail, which is becoming increasingly pronounced and may be causing discomfort.

Firstly, it’s important to clarify what you mean by "frozen toenails." If you are referring to a condition where the toenail is growing abnormally, possibly due to pressure from the underlying bone or other structural issues, this could be indicative of a few different problems. Common issues include ingrown toenails, fungal infections (like onychomycosis), or even more serious conditions such as nail dystrophies or bone deformities.

Given the symptoms you described—specifically the upward growth of the toenail and the potential involvement of the underlying bone—it would be advisable to consult a podiatrist. Podiatrists specialize in foot and ankle conditions, including toenail problems. They can assess the nail's condition, determine if there is an underlying bone deformity, and recommend appropriate treatment options.

If the podiatrist finds that the issue is related to bone structure or alignment, they may refer you to an orthopedic specialist. Orthopedic surgeons focus on the musculoskeletal system, which includes bones, joints, ligaments, tendons, and muscles. If there is a deformity in the bone that is causing the toenail to grow improperly, an orthopedic evaluation may be necessary to address the structural issues.

In some cases, if the toenail condition is severe or requires surgical intervention, a podiatric surgeon (a podiatrist with surgical training) may perform the necessary procedures to correct the nail's growth pattern or address any underlying bone issues. This could involve nail removal, correction of the nail bed, or even surgery on the bone if necessary.

You mentioned that you have not experienced significant pain, which is a good sign, but it is still important to address the deformity before it potentially leads to more serious complications, such as infections or chronic pain. Early intervention can often lead to better outcomes and prevent further issues down the line.

In summary, I recommend that you first see a podiatrist for a thorough evaluation of your toenail condition. They will be able to diagnose the issue accurately and determine whether you need further treatment from an orthopedic specialist or if the problem can be managed within their scope of practice. Remember, it’s always better to address these concerns sooner rather than later to maintain your foot health and overall well-being.

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