Another lame medical question

October 4, 2007 12:07 PM

MedicalQuestionFilter: Thumbnail looks like a tectonic plate. Should I go see the doctor? (Warning: Not for the squeamish)

I can't believe I'm asking a medical question on Metafilter.

On Monday I had a workplace accident, where I sliced through the my thumb with a box cutter. The knife went right through the fingernail horizontally as well as flesh on one side of the thumb. I went to the emergency room, where the nurse had a look at it. She super glued the nail together along the cut line and then bandaged up the thumb. She then told me that when the bandage comes off in a few days to put clear coat nail polish on it to keep it from snagging on things.

I took the original bandage this evening and had a look at the nail. I had thought that the 2 nail sections would be fairly flat but instead it looks like the top section of the nail has shifted on top of the lower portion.

My question is this: I'm pretty sure that the top part of the nail is shot (and will be replaced by the growing lower section). I just want to know if I should be worried about the appearance (like one tectonic plate sliding under another) and go back to the doctor or just let nature take it's course.

Additional information: I cleaned around the wound area and everything looks ok. There is no pain except when I accidentally bump the thumb into something.

posted by smcniven to health & fitness (10 comments total)

If you go to the doctor they'll probably remove the top part. If you sit and wait it out, nature will probably do the same thing, only in a longer more painful way. Or the top half may die out and fall off rather painlessly.

If it were me, I'd probably wait it out.
posted by sanka at 12:10 PM on October 4, 2007

i'm no doctor, but that makes sense to me- nails grow from below the cuticle, so only the bottom half (the cuticle half) is still growing. the top half (thumbtip half) is attached to the skin beneath it, and is no longer being pushed off your thumb by the growing part behind it.

i think the bottom, growing half, will eventually wedge right under the tip part and just push it off in a couple weeks- it will gradually start to be less-attached and you'll snag it on something & painlessly rip it off. i do not have medical training and i have never seen this exact kind of injury. but no pain and a clean-looking wound is a good status quo, i think.
posted by twistofrhyme at 12:12 PM on October 4, 2007

I did something similar with my brand new super sharp kitchen knives, sliced right through my thumbnail and thumb.

Don't worry about it, the top is going to fall off naturally. If it starts snagging on stuff and hurting, then I'd go just to have them cut it off if you don't feel comfortable doing so.

Also, I have to say, it heals & the nail grows back surprisingly fast.
posted by tastybrains at 12:23 PM on October 4, 2007

I did something similar to my big toe once. Yes, just keep it clean, and maybe covered to keep it from snagging on stuff. It'll fall off eventually, but you can have a doctor speed things up. I waited until friends insisted that I go to the doctor. When I did, the doctor actually said, "What do you want me to do? Pull it off?" I left it, it came off on its own, and it wasn't even hurting anymore by then.
posted by sa3z at 12:32 PM on October 4, 2007

IANAD, but I am a tangential data point. When I was about 4, I got cut very badly on my thumb by a falling teapot (according to family legend). It sliced vertically through the entire nail and the cut extended about a centimeter past the nearest thumb joint. My dad is a doctor, he rushed me to the emergency room, stitches were applied and the thing was looked at constantly. It didn't do any good. My nail now grows with a very prominent ridge straight down the middle.

I think that slashed fingernails will end up how they want. I don't think that there's anything you can do about it.
posted by 23skidoo at 2:01 PM on October 4, 2007

When my son did this (age 1 1/2) the ER nurse said we only had to come in if the cut had gone into the cuticle part (where it grows from). Being unsure and neurotic, we went in. There was a young ER doctor there who was specializing in finger injuries. He seemed quite disappointed at how mild the injury was. He said we could put a band-aid on it if we wanted, but it was optional. The nail grew out. No band-aid. I'd let nature take its course.
posted by selfmedicating at 2:12 PM on October 4, 2007

Is it wrong of me to have clicked in here hoping for a picture?

I would go back but that's because this stuff freaks me out.
posted by agregoli at 2:41 PM on October 4, 2007

LOL. I made the mistake of showing my 2 year old when I took off the bandage. He was so horrified that I had to rebandage before thinking of taking a picture!
posted by smcniven at 3:40 PM on October 4, 2007

Is it wrong of me to have clicked in here hoping for a picture?

I was totally expecting one, too. Maybe it would help us help you better, smcniven. ;-)
posted by tastybrains at 3:59 PM on October 4, 2007

For the advancement of medical science, behold my thumb (self-link)
posted by smcniven at 2:49 PM on October 5, 2007