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Losing toenail 3 years aftet Hammertoe surgery

by P.J.
(Dallas, Texas)

I had hammertoe surgery 3 years ago. A few weeks ago I noticed what appeared to be a small bruise on the second toenail right at the cuticle of the foot that had the surgery. Two days ago the nail split completely down the middle but was still attached a the sides. My pedicurist said he could not see a new nail under the old split one. What would cause this & will I regrow a nail? There is no soreness or pain. Didn't hurt when it split sown the middle. Thanks so much


RESPONSE
Hi PJ,

I think it is strictly coincidental that the nail fell off the toe that underwent surgery three years ago. Since the growth of a nail especially on the smaller toes is about 4-6 months for complete regrowth, had your surgery been performed more recently, I might have made a connection between the two.
In most instances the black spot represents bleeding underneath the nail which then loosens the nail off the nail bed and in some cases it can cause the nail to fall off.
Even though you may not recall actually injuring the toe you may have sustained what I call repetitive micro trauma to the nail. An example would be if you run on a treadmill or play a lot of tennis.
As you move about, the end of your toe is constantly being jammed into the end of the shoe and after a while the cumulative effect is trauma to the nail and sometimes bleeding underneath.
In most instances this is a benign situation and a new nail will begin to grow out. You will want to take precautions to make sure the new nail does not develop any fungal infections as this situation does raise that risk.
One note of caution. As I just stated, most cases of a dark spot under the nail particularly at the back of the nail is nothing more than a little bleeding.
When your new nail begins to grow out again, if there is that same black spot again, it would behoove you to see a foot specialist or a dermatologist and have the black spot biopsied. Sometimes and very rarely I might add, the black spot may actually be a melanoma, so once again, if the black recurs, have a doctor take a look at it,just to be on the safe side. Do not rely on your pedicurist for medical advice.

Marc Mitnick DPM
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