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Black toenails and drilling

Discussion of medical or rescue topics related to climbing and mountaineering.
 

Re: Nail surgeon

Postby aglane » Wed Jan 18, 2012 3:06 am

Tim Stich wrote:Just insert a sterilized needle underneath the toe nail and it will pierce the blood blister and drain that way. The nail is already partially lifted from the nail so you don't have far to go. This should be painless, also.


I'll disagree here. The needle would be painless if the nail if fully lifted at the tip (but wouldn't it then have drained already?). And supercautious that I am, the needle seems to introduce a higher infection risk by penetrating flesh, while I've never in several episodes had the red-hot paperclip go to the flesh, the floor under the blood blister.
The need for a mechanical drill escapes me.
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Re: Black toenails and drilling

Postby E_Rolls » Wed Jan 18, 2012 4:23 pm

I have drilled nails in the past (hands and feet) and it works well only when there's pressure from a blood blister. From shoes I've only gotten bruised cuticles and drilling doesn't do a thing for me. Prevention is the way to go. I have thick side curved nails and after cutting them as short as possible, injury is still a real possibility. What has helped a great deal is after cutting the nails I take a file to the top of the nail and "taper" the end down to the top of the toe. Kinda like forming your foot to fit your boot. After losing 4 toenails from bruising I started doing this before any outings and have had 100% success in nail injury prevention. YMMV. Also,I use a real coarsish file. Not a fingernail file. Otherwise you'll be there all night filing.

-E
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Re: Black toenails and drilling

Postby mtneering » Wed Jan 18, 2012 11:44 pm

IMHO don't ever open your integumentary system to infection. Even burning the needle or alcohol prep doesn't prevent long term chance of infection that can access your body through the open skin/nail. This applies to blisters also!
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Re: Black toenails and drilling

Postby peninsula » Wed Feb 08, 2012 4:49 pm

mtneering wrote:IMHO don't ever open your integumentary system to infection. Even burning the needle or alcohol prep doesn't prevent long term chance of infection that can access your body through the open skin/nail. This applies to blisters also!


It is true, most intact blisters will heal better without opening them. The skin, hair, and nails (integument) are referred to as a primary defense mechanism when it comes to our immune system, and leaving these tissues intact is an absolutely valid objective. I have a hard time not picking away the dead skin after a blister has dried or started to peel, another mistake! Taping skin blisters (open or closed) with a thin medical adhesive tape provides the most effective therapy when it comes to protection (3M Micopore tape is a stellar performer!). However, when it comes to blood-blistered toenails with painful pressure buildup, definitely relieve the pressure! It offers instant gratification... definitely satisfies the scab-picking side of me. If you have a healthy immune system and exercise reasonable hygiene, the odds of infection are remote.

I've had my share of black and blue toenails over the years, both with running shoes, cycling shoes, and hiking boots. I advocate getting shoes with an extra roomy toebox. You got to try them on and learn by trial and error. It seems reasonable to assume a roomy toe box is good for everyones' feet even if they don't need the extra room.

A hiking boot with a generous toebox: http://www.backcountry.com/asolo-moran- ... erralID=NA

Trail running shoe " ": http://www.montrail.com/Men%27s-Mountai ... lt,pd.html
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Black toenails PREVENTION

Postby robertjoy » Wed Feb 08, 2012 5:32 pm

Long ago, as a runner training long distances, I found that I would get "black toenail" even if my big toe was never touched the front end of the shoe. My problem was that the top edge of my big-toe nail was slightly rubbing upward against the inside of the shoe: not noticeable until the nail turned black. My solution was of course "trim the nail as short as possible. That did not work. The solution I settled on was to trim the nail reasonably short, and then to file the top edge of the nail so that it was smooth and would not "catch". To reduce friction even further, I first followed up with a common emery board, but now I use a ladies manicure "polishing board". This has 3 different degrees of "fineness", and after using all 3, the nail is like teflon. If friction on the nail is your problem, this is a very simple and painless solution, although you may attract some comments about your ultra-glossy toenails!
http://www.amazon.com/Shany-Premium-sid ... 271&sr=8-1
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