Toenail Removal and Reattachment: Is It Necessary?

Q: Toenail Removal and Reattachment: Is It Necessary?

Hello： The nail that was reattached is only a temporary protection for the underlying nail bed tissue. <br>After the sutures are removed, the nail will gradually fall off, but this will not affect the growth of the new nail.

Toenail extraction

Hello doctor, on the night of July 4th, I accidentally kicked a door, which resulted in my right foot's fourth toe nail being partially lifted.
After going to the emergency room, the doctor first removed the nail, then cleaned and organized the area before placing the nail back onto the nail bed.
Finally, they used a hook to stitch through the flesh and the nail on both sides.
Is this treatment reasonable? Since the nail was already removed, why put it back? Won't this cause the new nail to grow back improperly? I hope you can clarify this for me, thank you!

Ma Ke Li, 20~29 year old female. Ask Date: 2010/07/04

Dr. Huang Junxiong reply Surgery

Hello: The nail that was reattached is only a temporary protection for the underlying nail bed tissue.
After the sutures are removed, the nail will gradually fall off, but this will not affect the growth of the new nail.

Reply Date: 2010/07/04

More Info

When it comes to toenail injuries, particularly those involving partial avulsion or complete removal of the nail, the treatment approach can vary based on the specific circumstances of the injury. In your case, it sounds like you experienced a significant injury to your toenail, leading to its partial detachment. The decision to remove the nail and then reattach it is not uncommon and can be justified for several reasons.

Firstly, the primary goal of treating a toenail injury is to promote healing and prevent complications. When a toenail is partially lifted or damaged, there is a risk of infection, and the nail bed may be exposed to bacteria and debris. By removing the nail, the medical team can clean the area thoroughly, ensuring that any potential contaminants are eliminated. This step is crucial in preventing infection, which can complicate healing and lead to more severe issues.

After cleaning the area, reattaching the nail can serve several purposes. One of the main reasons for reattachment is to protect the nail bed as it heals. The nail itself acts as a natural barrier, shielding the sensitive tissue underneath from external trauma and infection. Additionally, reattaching the nail can help maintain the proper shape of the nail bed, which is important for the future growth of the new nail. If the nail bed is left exposed without the protection of the nail, it could lead to irregular nail growth or even permanent deformities.

Regarding your concern about the new nail potentially getting caught or growing improperly, it is essential to understand that the nail growth process can be influenced by various factors, including how well the nail bed heals and the care taken during the recovery period. In most cases, if the nail is properly reattached and the area is kept clean and protected, the new nail should grow back normally. However, it is crucial to follow your doctor's post-operative care instructions, which may include keeping the area clean, avoiding tight footwear, and monitoring for signs of infection.

In some cases, if the nail is too damaged or if there is significant risk of complications, a doctor may opt for complete removal of the nail rather than reattachment. This decision would be based on the specific injury and the likelihood of the nail growing back properly.

In summary, the approach taken by your medical team—removing the damaged portion of the nail, cleaning the area, and then reattaching the nail—was likely aimed at promoting healing and preventing complications. While it may seem counterintuitive to reattach a damaged nail, doing so can provide protection and support for the nail bed during the healing process. If you have ongoing concerns about the healing process or the appearance of your toenail as it grows back, it is advisable to follow up with your healthcare provider for further evaluation and guidance. They can monitor your recovery and address any issues that may arise, ensuring the best possible outcome for your toenail health.

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