Toenail trauma is very common and can create panic to many people. The biggest question is “what do you do to the toenail?”. Here are some guidelines on what to do if you injure your toenail.

If the nail is loose, it needs to come off.  Bleeding can accumulate under the nail plate which can create pressure and cause tissue death to the nail bed under the nail plate.  The bleeding can also become stagnant leading to infection. When in doubt, the nail needs to come off.

If trauma occured to the toe, there could be an underlying fracture of the bone. This could be an open fracture with a laceration through the nail bed.  In this case the nail must be removed and the lacerated nail bed would be sutured after throughly flushing out and cleaning out any debris.  Failure to remove any debris or bacteria from the open fracture site could result in bone infection

So, if you did anything to injure your toenail, especially by dropping something on it or smashing it, it’s crucial to have it looked at. You could have an open fracture which could easily become infected and possibly lead to a bone infection.

Example of foil used to preserve nail bed. ER physician performed and sent to my office.


ER attempt to save toenail which was unsuccessful. I had to remove the toenail which will eventually grow back but possibly deformed.

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