What is nail trauma?

Nail trauma is a common occurrence that is usually caused by stubbing or dropping something on the toe, abnormal biomechanics, repetitive micro-injuries caused by excessive use or pressure arising from ill-fitting footwear.

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Forms of nail trauma can range in severity, with a common outcome being a subungual hematoma—a dark discoloration resulting from blood pooling beneath the nail. In more severe instances, nail trauma may lead to the splitting or detachment of the nail from the nail bed, or it can cause fractures in the underlying tissue or bone.

Risk factors

This condition can affect individuals of all genders and ages, often resulting from nail injury. However, certain groups of people may experience nail trauma more frequently, such as runners and individuals who wear ill-fitting shoes. Intensive running can lead to bleeding, blistering, or black toenails due to repetitive microtrauma from shoe impact. Ill-fitting shoes, whether overly tight or loose, can squeeze toes together or cause repetitive toe-to-shoe contact.

Possible Complications of Nail Trauma Injuries

If left unaddressed, nail trauma can lead to infections with bacteria, fungi, or viruses, spreading to other nails, tissues, or even bone. Infections may require advanced therapy and prolong recovery.

Unresolved nail trauma can also lead to long-term problems like abnormal nail growth, ingrown toenails, unsightly nail deformities, and other conditions. A damaged nail matrix (where cells that make up the nail plate are created) may also lead to a complete loss of the nail.

In rare cases, subungual melanoma, a type of skin cancer, can resemble nail trauma, manifesting as vertical brown or black discoloration. If unusual discoloration occurs, especially without an obvious cause, consult a podiatrist promptly.

How can nail trauma be managed?

Mild cases may only require offloading during healing, while complex injuries, like fractures, necessitate a thorough examination and diagnostic tests such as ultrasound or x-ray.

Assessments help determine damage extent and the best course of action. Nail deformities may require minor surgical procedures with follow-ups for proper healing.

Patients with biomechanical issues may receive custom insoles to prevent further microtrauma. Timely intervention is crucial to prevent long-term unsightliness and complications. Consult a podiatrist to discuss options and preventive measures.

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Common Symptoms

Black toenails

How It Looks Like

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Great experience and swift damage control due to sudden trauma of my toe. Recovered well and I'm all good now! :)

Joan Chin

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