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to remove or not to remove

Discussion in 'Introductions' started by taipanclarke, May 4, 2013.

< Another newbie.. | Coding question 11042 >

taipanclarke Welcome New Poster

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Self referral with an avulsed right hallux toenail. Patient had rang the surgery saying he stubbed his nail on a bucket early in morning, he said nail had 'rolled back on itself'.
O/E right hallux nail avulsed distally approx 50% of nail lifted from nail bed and folded back, some of lifted nail had been cut away by patient .
No evidence of bruising although blood visible at distal nail bed and swelling proximally at nail matrix same spongy to touch and painful. Patient had some pain although has been taking pain killers throughout the day and bathed foot in salt water.
Discussed possible damage to nail matrix and that nail may grow differently as matrix may be damaged. Digital block achieved nail had lifted at distal nail bed and matrix advised removal to allow new nail to grow unimpeded as nail had broken from matrix. Clean avulsion of nail obtained.
Just wondering was removing the nail the only or best option or should it be left insitu and follow a watch and see approach

taipanclarke, May 4, 2013

#1