Undergoing an ingrown toenail operation

© October 2011 Paul Cooijmans


"Before" - This is actually the current left toe, mirrored.
"After" - 24 years after the operation. The "extra" nail, about a millimetre wide, is seen near the bottom left corner of the nail, cut short here.

In 1986 my right big toe became inflamed at the outside edge of the nail, probably through infection after trying to remove dirt from under the nail and accidentally causing a small wound there. It did not get better by itself or with sodium carbonate foot baths, and also not with treatments the doctor tried, such as putting silver nitrate on it. Eventually the inside edge (next to the second toe) became inflamed as well. Although I myself saw it as the result of a small wound that got infected, the doctor called it an "ingrown toenail", and also noted that the nails of my big toes were very broad, which increased their risk of growing in. After six months, he advised surgery.

The operation

Before the operation I was given local anaesthetic by means of two injections in or near the joint between the toe and the foot, one on the inside and one on the outside. It felt like the needles went deep into the joint and stayed there for almost a whole minute, all of that time causing quite severe pain, similar to the pain of an injection in the ceiling of the mouth. The operation itself did not hurt. The nail was made narrower by removing two slices from it - one on each side -, including the corresponding piece of nail root. Also, the inflamed toe material was removed, so that effectively the toe became smaller and the nail was lying flat on top of it, instead of between two "walls" of skin and flesh.

To keep everything together, a length of sticking plaster was wound very tightly around the toe, and then bandage around that. I was sent home with the instruction to keep the foot high, also at night in bed, and take pain killers if needed.

After the operation

The pain after the anaesthetic had stopped working was not too bad. The first nights were problematic; I could not sleep lying on my back with one leg up on a pile of pillows (I do not fall asleep when on my back), and when I accidentally stretched the leg too far this pulled on the wound, causing a sharp, unbearable pain. When during later nights I did succeed falling asleep, I was now and then woken up by this extreme pain after inadvertently stretching the leg in my sleep. I am fairly certain that on one of those occasions, about a week after the operation, the outside wound has been pulled open, separating a small piece of nail root from the rest, so that I now have a small extra nail there, which has to be cut separately. I told the surgeon about this event one or two days after it had happened, but he looked at the toe and said nothing was wrong, although there was a lot of blood in the bandage. During the first weeks after the operation, I wore a right shoe wherefrom part of the front had been cut away, to leave room for the bandaged toe.

The problem with the stretching of the leg pulling on the wound lasted long, and only very slowly got better. It took several months before I was able to stretch my leg fully again with the toe forward. When, about two weeks after the operation, the bandage was removed permanently, I was initially unable to move the toe, and had to relearn it by taking it between my fingers and moving it up and down a bit. It was not so that the toe was "stiff", as people often mistakenly say in such a case; the matter was that after the toe had been wrapped in bandage for almost two weeks, I had "forgotten" how to use the motor nerves leading to it. I practiced every day to re-find them, and after a few weeks had advanced so that I could move the toe better than I could the one on my left foot. This has always remained so; the right toe moves a bit easier and is more flexible than the left toe. That may also have to do with the right toe being smaller now. I have never gone back to a doctor about the extra nail, as it can probably not be fixed without a new operation, which I would not want.