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Unable to bend toe, nail bed is painful. Active runner. Had toe nail removed for infection. Suggest?

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Posted on Fri, 17 May 2013
Question: I am an active runner. Last december I had my toe nail removed because of an infection. The nail has grown almost 75%. However the area around the nail bed is somewhat painful. Also I am unable to bend my toe. I feel lot of pain while doing so. I dont feel any pain while running. Can you suggest some remedy.
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Answered by Dr. Geetika Paul (39 minutes later)
Hi XXXXXXX

Thanks for the query.

I completely understand your concern and I hope I am able to help you for the same.

You had a complete nail avulsion (removal) done few months back due to some infection as you state. As you are an athlete, I presume you may have had a traumatic nail injury leading to infection resulting in the nail removal. However as chronic fungal infection is also treated by nail removal, I would be interested to know the exact circumstance that led to nail avulsion.

In either case, now since you are still having pain after regrowth of nail, there is a possibility that the same infection is still persisting. Whenever a nail removal is done for some infection, it is very important to remove the entire nail, including the nail matrix. Sometimes infections persist in this area.

Amongst the common infections leading to such presentations, we have bacterial and fungal infections. Combination of antifungal and antibiotic such as weekly fluconazole therapy along with cephalosporins is entailed.

In brief, since the possibility of persisting infection cannot be excluded based on symptoms, I suggest that you see your treating doctor to assess the exact condition and give you a course of antibiotics /antifungal as specified above. In the interim anti-inflammatory pain killers and restricting toe movements can be helpful. You also need to avoid any kind of further trauma to your toe nail.
Wear soft canvas shoes or open footwear as much as possible. Avoid wearing shoes with a pointed edge, so as to provide enough space for the toes. Avoid application of any kind of oils/moisturizing creams to feet.

Hope I have answered your query. If you have any further questions I will be happy to help.

Take care

Wishing you speedy recovery

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Geetika Paul (1 hour later)
Thanks Dr. XXXXXXX

Yes the injury was because I was wearing a tight fitting shoe during practice. Basically I am a marathon runner. The infection was healed. However since the first day of surgery I am not able to bend my big toe. I am able to move it up and down, but not able to bend it (making an L shape). I am planning to visit an orthopedic doctor today. Do you think he should be the right person to consult now? or should I visit the general surgeon who operated my toe nail?

Regards,
XXXXXX
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Answered by Dr. Geetika Paul (25 minutes later)
Hi XXXXXXX

Thanks for the query

I would definitely recommend an orthopedic opinion, as there seems to be some problem with the metatarsal joint or it may be something related to the tendons. I am sure an orthopedic surgeon would be of more help to you...

Best wishes for a speedy recovery
Dr Geetika Paul


Above answer was peer-reviewed by : Dr. Prasad
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Dr. Geetika Paul

Dermatologist

Practicing since :2008

Answered : 2606 Questions

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Unable to bend toe, nail bed is painful. Active runner. Had toe nail removed for infection. Suggest?

Hi XXXXXXX

Thanks for the query.

I completely understand your concern and I hope I am able to help you for the same.

You had a complete nail avulsion (removal) done few months back due to some infection as you state. As you are an athlete, I presume you may have had a traumatic nail injury leading to infection resulting in the nail removal. However as chronic fungal infection is also treated by nail removal, I would be interested to know the exact circumstance that led to nail avulsion.

In either case, now since you are still having pain after regrowth of nail, there is a possibility that the same infection is still persisting. Whenever a nail removal is done for some infection, it is very important to remove the entire nail, including the nail matrix. Sometimes infections persist in this area.

Amongst the common infections leading to such presentations, we have bacterial and fungal infections. Combination of antifungal and antibiotic such as weekly fluconazole therapy along with cephalosporins is entailed.

In brief, since the possibility of persisting infection cannot be excluded based on symptoms, I suggest that you see your treating doctor to assess the exact condition and give you a course of antibiotics /antifungal as specified above. In the interim anti-inflammatory pain killers and restricting toe movements can be helpful. You also need to avoid any kind of further trauma to your toe nail.
Wear soft canvas shoes or open footwear as much as possible. Avoid wearing shoes with a pointed edge, so as to provide enough space for the toes. Avoid application of any kind of oils/moisturizing creams to feet.

Hope I have answered your query. If you have any further questions I will be happy to help.

Take care

Wishing you speedy recovery

Dr Geetika Paul