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Infection under the nail after injury - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Skin Hair and Nails
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2305 Questions
User :   my twelve year old son smashed his thumb nail in a car door....thumb not broken but after two weeks it is getting whiter from the cuticle left corner he has some slight pain on contact and redness and now we havve noticed an odor from the this all normal? Nail seems to be lifting a bit. Also, he was given antibiotics though. He has not lost any mobility and is feeling fine thanks!
Doctor :   let me read your query
Doctor :   From the history, it seems that a new nail is developing in the the injured thumb.
Doctor :   Some tenderness or pain will be present for some time until complete healing of the thumb and separation of the old nail occurs
User :   What is the odor from and should i have him seen by me gp
Doctor :   Presence of the odor, could be due to collection of fluid under the nail bed
User :   What do u think an infection would look like? There is no additional swelling.
Doctor :   presence of infection in the thumb, will present with increased pain, yellowish discoloration, and inability to move the thumb
Doctor :   You might consider consulting your GP, who may examine and then decide whether there is infection
User :   What is the course of action for infection
Doctor :   Use icepacks and a bandage to support the thumb for the moment
Doctor :   If the collection of fluid is increased, it may need to be removed
Doctor :   and a course of antibiotics with proper wound dressing will help
User :   Can that be done in office
Doctor :   Yes
Doctor :   this is a very minor procedure done within minutes
Doctor :   and not painful either
Doctor :   I hope i have solved your query
Doctor :   Do u have any other medical query?
User :   The worst part of the nail is along the rim below the cuticle, that is where the door shut on it and where there was a small cut. I am surprised he would develop this after two weeks....we have been cleaining this regularly and was healing nicely.
Doctor :   Is there any swelling or pain at the tip of the thumb tip ?
User :   no not really,thumb was swollen but has decreased. The nail itself just seems to be raised
Doctor :   once you have a injury of the thumb, a slight collection of fluid, will occur below it, and will reduce as the healing process is completed.
Doctor :   the nail elevation occurs as it is due to separate, with a new nail regenerating below that
Doctor :   thats completely normal in most cases of nail injury
Doctor :   Since the thumb swelling has reduced, it means that the healing process is almost complete
User :   When changing bandaid daily, I noticed some yellow clear fluid (not thick at all) draining from time to time but that has since stopped.
Doctor :   that's a good sign
Doctor :   and no need to worry at all
User :   The smell has me rattled......thank you for all your help.
Doctor :   since the fluid draining has already stopped , most part of the wound healing is complete
Doctor :   The nail separation may be completed within a week or so
User :   Can that smell mean infection?
Doctor :   No
Doctor :   It means that the nail separation is complete and nail may separate,
Doctor :   anytime soon
User :   you have been a great help......thanks again. I think I will have it looked at tomorrow, just so he may need the antibiotics
Doctor :   if the smell is very pungent and associated with think purulent discharge, and severe pain - that indicates infection
Doctor :   thick
Doctor :   consulting your GP, who may examine and then decide whether there is infection is the best step here, and will benefit the most.
Doctor :   thank you for consulting me here
Doctor :   bye for now
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