Hi all
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I'm looking for some advice about a 69 year old male patient with a two year diagnosis of motor neurone disease. (He is still relatively mobile)
He presented to me two weeks ago with a grossly swollen great toe due to a chronically in-grown toenail. This toe is quite neuropathic hence the delay in seeking treatment. I'm hoping to try and resolve this conservatively, ie cutting the nail spike out, packing the sulci and changing his current narrow footwear, but have a feeling it will require surgical intervention.
Does anyone have any knowledge or experience of carrying out a nail avulsion with regard to use of local analgesia in MND? Are there likely to be any contraindications?
Any advice greatly appreciated.
Gill
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