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When a bone spur meets the ingrown from hell.

Discussion in 'Ask your questions here' started by Nadine, Jan 2, 2018.

  1. Nadine

    Nadine New Member

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    First off, I definitely require surgical intervention on this one. Bear with me: this is long, because this is kind of a 20-year problem.

    I have a bone spur at the tip of my left great toe that's impacting on the growth of my toenail.

    It's steadily growing in size. It's not a 'broken through' style one, but it's deviated the nail so it's doing that curvy sloping thing, which is pretty interesting. Also painful, which is not great.

    The bone spur is likely caused by the massive amount of trauma that this toe has seen.

    I have had not one but SIX failed surgeries on this toe by a parade of extremely, well, arrogant, short-sighted and perhaps deaf GPs and general surgeons who either didn't care or felt themselves special and different after I told them that phenol didn't work the first time.

    I had an ingrown toenail at age 14. My mother, being a bit of an overprotective sort, in her wisdom, took me to the GP. It had been two whole days since I wore a pair of high heels for the first time, ended up on my feet for 12 hours and ended up with an ingrown. She got a bit too excited by it. In retrospect, it completely could've been fixed conservatively.

    However, on the spot he did some sort of ablation thing that included heat (that's the only procedure I don't remember much of, because I fainted on the table after he failed to anaesthetise me correctly and it burned like hell).

    Anyway, it grew back. Naturally.

    And it was ingrown. I'm now 35 and, on five more occasions, it's been surgically operated on. I've had both wedge resections and partial nail avulsions. All used phenol. All failed. Each time, the section of nail regrew, and regrew even deeper.

    The last time, a general surgeon went with general anaesthetic and left the wound open after. My surgical consult was so masterful he sent in a first-year resident to deal with me who ignored all my questions and when I complained he came in and talked over me and insisted very loudly that phenol would work and basically that everyone else must've just been stupid.

    Four weeks later, a different first-year resident had a look at my toe when I went back for my post-op check. She didn't palpate and she also ignored me when I told her that I already felt a shard of nail regrowing. She signed off on it and I was cut loose from the hospital aftercare.

    This time, however, the regrowing is catastrophic. It hasn't just regrown. It's growing at a ninety-degree angle directly into the skin. It's sort of like a river. I have to draw diagrams to try to explain to people what it's doing rather than show them the horror. I've taken to painting my toenail to hide it. Otherwise, to be honest, it doesn't look gross. It looks gruesome. And there's something weird happening with blood flow, because if it's not red, then it's purple.

    My GP is generally a smart guy, and by this stage not one of the failed ones who operated on me, and he went, "But that can't be nail! Toenail doesn't grow there! Or like that!"

    I'd love to know what he thinks it is. Treasure, maybe. He tapped it with a pen. He looked mildly terrified.

    The regrowing shard started to put pressure on the normal bit of nail that was also under pressure from the bone spur. So that started to curl inwards also, so it's doubly ingrown. After the complete and utter failure of everyone to deal with it (my GP won't touch it and keeps telling me to go back to a general surgeon, and to be honest I think this is the worst idea of all time), I have been managing it on my own.

    This has involved a pedicure kit. I've had no choice but to cut off the ingrown part of the normal nail that's curling under. It relieved a hell of a lot of pressure. However, as for the regrown shard, once my pedicure tool died, it started to look like any foreign object embedded in the skin, and I'm dealing with constant foot soaks to reduce skin swelling. I won't have yet another wedge resection or partial nail avulsion with phenol. I've accepted at this point there's probably no way to save the nail. The section of skin surrounding the regrown shard is so swollen around it that it's impossible to tell how deep the nail goes. If I soak for a while to reduce swelling and pull the skin back a bit with tweezers, I see it's embedded at least 5mm in, but based on how far the redness extends, I'd say it's at least 8mm.

    I'm not sure if my best bet is to go with a foot and ankle surgeon or podiatric surgeon and I'm at a loss here. Maybe I should consult a cosmetic surgeon? No idea. I've been dealing with this for twenty years now.

    Currently, I can't wear enclosed shoes without intense pain. I'm struggling with the weight of bed sheets.

    Pertinent facts: I have Ehlers–Danlos hypermobility type and a predisposition towards early onset osteoarthritis. My mother has hallux rigidus of her left great toe and other similar conditions to me. I'm in Melbourne, Australia. I don't wear too-tight shoes or do any of the dodgy things that pre-dispose you to ingrowns. I learned a long time ago not to do those, but when they've structurally stuffed up the nail, there's not a lot you can do.

    Is it worth my while chasing down a podiatric surgeon? What will they likely do? I really don't want to go under general anaesthetic again. I have a passionate hatred of it.
  2. Craig Payne

    Craig Payne Active Member

  3. Lspa

    Lspa Guest

    Ouch. That sounds miserable! I would most definitely go to a podiatric surgeon.

    They make some things that lift the weight of the sheet off your feet. You can go to toe-tents.com and check them out, there are a couple other types of products that do the same thing, but this one seems easiest.

    If the PS doesn't work - give a call to an orthopedic surgeon - they can fix anything. Maybe just call and ask....

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