I recently had a female (21 years old) who had a baby 8 months ago.
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She has had persistant involuted nails since mid-pregnancy and was trying to manage them conservatively with another podiatrist.
She presented to me 2 months ago, with obvious infection of both hallucis. Her toes were VERY FLESHY along with the inflammation from infection. She was limited to wearing thongs.
I recommended she get a dose of antibiotics from the GP, then returned to me in 1 week for a PNA bilaterally of both hallucis.
This was performed well and neatly, clear of nail sulci, and dressed. Looked ok at redressing interms of healing, though there were again the overlapping flesh causing discomfort.
Post op instructions of daily salt bathing and redressing until healed.
1 month later she has returned as pain is still present. There is no nail spike, just the continued problem of there being too much meat on her toes!
Any ideas for management? I am a little lost for ideas. TNA? (seems a bit extreme.)
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