I lost the toenail off my big toe

[Jerry Adams]

I dropped a concrete brick on my toe and the toenail slipped right off.  I didn’t think it was anything bad, except the toenail was sitting there off the end of my toe barely connected.

Urgent care said maybe the toe is broken

ER xrayed and said toe wasn’t broken, cleaned everything up, put the toenail back on and sutured it to help things heal.

I think losing a toenail is somewhat common for hikers.

When will I be able to hike again?

Should I wrap my toe in a bandage or something while hiking?

[Philip Tschersich]

My big toenail just fell off too, but it was the result of a series of really big mile days of offtrail backpacking back in June. It turned black and then 2 months later finally separated. But during that whole time, I never stopped hiking.

The sutures are a different deal in your case. I understand them wanting the nail to stay in place to protect the nail bed while things heal, but stitching it on seems weird. I’m no doctor, but I think the sutures are the issue and not the loss of the nail itself.

Why not ask the doctor what they recommend?

[Jerry Adams]

thanks

remove sutures in 14 days.  I think I’ll take it easy until then regardless.

so you never put any bandage around your toe?  That seems weird to have an uncovered nail bed and just hike normally.  It would get dirty or something.

 

[Ben C]

Mine hurt like the devil.  Mine came off completely.  No one sewed it back in place.  I remember it taking quite awhile for it to grow back to the point I would want to hike.

I lost a fingernail too, It was a lot more painful, but at least I didn’t have to walk on it.

[Ken Thompson]

Give it a year.

[Jerry Adams]

mine didn’t hurt that much, maybe 5 on a scale 0 to 10.  It’s maybe 1 right now.  When she injected novacaine into the sides of my big toe it was maybe 9.

how long did it take before you were able to hike again

[Ron Bell / MLD]

Lost big toenails a few times after ultra runs/very long hike days/ full IM’s.  Cause was from excessive banging of toe/nail into the end of the shoe. Turned black, trapped blood and clear fluid, I lanced it and all discomfort immediately ceased then a few weeks later I started clipping off dead/disconnected pieces until it was back to the quick. No pain and no problem continuing to run throughout process. Took 9mo to grow back.

[Ben C]

“how long did it take before you were able to hike again”

I don’t really remember but I remember it was tender for quite awhile.  I was able to walk OK fairly soon but it took months to grow all out.

[Philip Tschersich]

My nail bed turned black a few days after my trip. It never hurt. The nail never really even felt irritated during the hike. But thousands of seemingly sub-injurious contacts with your footwear will cause bruising and damage, resulting in eventual nail loss.

I could tell the nail was a goner and that it was in the process of separating from the nail bed, but it was still attached at the cuticle, so I wasn’t about to yank on it. I did put a piece of tape around my toe to hold the nail in place the first hike or two, but the tape just slipped off after a few miles and wasn’t helping, so after that I was just a bit careful (when pulling my sock on, etc) and didn’t worry about it too much. I kept the end trimmed so that it didn’t catch on stuff. Just recently most of it released from the cuticle and I trimmed back those portions that I could lift free, but I still have about 20% of the nail in place. Eventually that will fall off too.

You might be in a slightly different situation since it was a quick trauma that separated the nail. Like the difference between an intact blister (sterile) and a popped blister (bacteria can get in). But if you can get through the suture period and the nail bed forms new skin, after that I think you would be okay.

Many years ago I separated a big toenail in the way you just experienced (sudden and violent trauma). It was still attached at the cuticle. The ER doc just shoved the nail back in place and bandaged it up. There was some pain, and I had to wear open toe footwear for a while, but it didn’t take long for the nail bed to skin over and I just waited for the rest of the nail to fall off of its own accord. I was probably wearing tape on that toe for a few weeks and took it easy. As long as you can tolerate the tape and discomfort, you can probably get back to normal activity pretty quick. It’s not like a broken bone. As soon as skin forms on the nail bed, you are solid (in my experience).

[Nick Gatel]

Lost big toenails a few times after ultra runs/very long hike days/ full IM’s.  Cause was from excessive banging of toe/nail into the end of the shoe. Turned black, trapped blood and clear fluid, I lanced it and all discomfort immediately ceased then a few weeks later I started clipping off dead/disconnected pieces until it was back to the quick. No pain and no problem continuing to run throughout process. Took 9mo to grow back.

Same here. Could hike/run in a few days. The toe looked ugly and took almost a year to grow back.

Edit: One other thing. When I started hiking/running the toe felt funny, not pain funny, but not having a toenail my brain recognized something had changed. In a day or two my brain determined it wasn’t an abnormal situation and quit sending me messages. Well, we can ignore the alien spaceship messages :-)

[Jerry Adams]

thanks for responses, sounds like things won’t be too bad

I think my injury was really clean.  The concrete edge landed on the middle of the toenail, and then forward motion pulled the toenail off.

for the last 10 years I’ve done a backpack trip every month.  Well, a couple times I’ve done, for example, the February trip first of March and the March trip in late March.  I’ve got until the end of September to do my September trip.

[Ken Thompson]

You will be fine by then.

[Todd T]

Stitched it back on?!  I think I’d rather drop a brick on the other foot.

[Jerry Adams]

the shots on either side of my toe were what was tough.  My wife and the doctor were holding my leg down and I was screaming (only slight exaggeration)

the sutures were when it was numb and I didn’t choose to watch

[Clifford Deakyne]

Good thing you didn’t break the bone!  Years ago, I had a similar weight drop on my toe, it pulled out the nail, split open the toe and shattered the bone tip.  The surgeon that stitched up the toe also used sutures to hold the bone fragments together til they healed, as well as suturing the nail back on as a splint for the bone.  Recovery time was more like 12 weeks.

Two weeks does not sound that bad.

[Pedestrian]

Pretty common among ultra runners to lose toe nails.

“Toe nails are dead weight”.

One Ultrarunning Problem, Solved for Good

[Author]

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