toe nail bruised. .. blood clot

by Nicole
(Brooklyn ny)

Good day, so about 2 weeks ago a heavy metal shopping cart fell on my foot I didn't see anything wrong, my toenail hurt and there was a blood clot on my left foot on the corner of my big toe. Couple weeks later now I still have on polish to be honest I was afraid to see what it looks like. So today I removed the polish today and my nail is pretty much green um only halfway green at the nail bed it's green and my cuticles are pretty dark. also a blood clot is there will the blood clot ever go away what should I do what can I do???? Will my toe nail go back to normal

RESPONSE

Hi Nicole,

Unfortunately, it sounds like you are going to need some medical care. I say this because the green discoloration is not a good thing. It either represents a fungal infection underneath the nail or even the possibility of a bacterial infection. Neither of these conditions is good to have.
In order to save the nail from permanent discoloration and thickness, the green discoloration and the bleeding underneath the nail needs to be treated.
When you have trauma to a nail and there is bleeding underneath and in your case a probable infection, this all has to be cleaned up.
Because of this situation the nail has lifted off its nail bed. By doing so you have dramatically increased the odds that there may be permanent damage to the nail and eventually the whole nail will become deformed leaving you with a very unsightly nail for the rest of your life.
In fungus infections when one nail is affected it can easily spread to the adjacent toes and then all your nails become deformed.
In bacterial infections you run the risk of a cellulitis and spreading of the infection. I should note that if you are young and in good health there is less chance of this happening but walking around even with a minor infection is not a healthy situation.
Treatment is probably not as bad as it may sound. In my office, I can usually cut away and drain a portion of the nail to clean up the green discoloration and any residual blood that may be underneath the nail.
Rarely does the whole nail have to be removed.
Depending on how much damage you actually did to the nail, at some point you may actually lose the nail. If the nail was traumatized enough, a new nail starts to grow underneath the old nail. At first you will not notice anything, but then all of a sudden you will start to notice that the old nail is starting to loosen up.
My suggestion is to not wait for this to happen, because at that point the new nail may be so damaged that you will end up with the type of nail deformity I have just described.
So, my advice to you is to see a local foot specialist and let he or she evaluate the situation. The doctor will decide to what extent the nail needs to be treated and this will dramatically reduce the possibility of having problems going forward.

Marc Mitnick DPM
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