Toenail or Fingernail Avulsion in Children: Care Instructions

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Your Care Instructions

Losing a toenail or fingernail because of an injury is called avulsion. The nail may be completely or partially torn off after a trauma to the area.

Your doctor may have removed the nail, put part of it back into place, or repaired the nail bed. Your child's toe or finger may be sore after treatment. Your child may have stitches.

There may be some swelling, colour changes, and bloody crusting on or around the wound for 2 or 3 days. This is normal. Taking good care of your child's wound at home will help it heal quickly and reduce the chance of infection.

The wound should heal within a few weeks. If completely removed, fingernails may take 6 months to grow back. Toenails may take 12 to 18 months to grow back. Injured nails may look different when they grow back.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

  • If possible, prop up the injured area on a pillow anytime your child sits or lies down during the next 3 days. Try to keep it above the level of your child's heart. This will help reduce swelling.
  • Leave the bandage on, and if your child has stitches, do not get them wet for the first 24 to 48 hours. Use a plastic bag to cover the area when your child showers.
  • If your doctor told you how to care for your child's wound, follow your doctor's instructions. If you did not get instructions, follow this general advice:
    • After the first 24 to 48 hours, remove the bandage and gently wash around the wound with clean water 2 times a day. If the bandage sticks to the wound, use warm water to loosen it. Do not scrub or soak the area. Do not let your child go swimming.
    • You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a non-stick bandage.
    • Apply more petroleum jelly and replace the bandage as needed.
  • If your child has stitches, do not remove them on your own. Your doctor will tell you when to return to have the stitches removed.
  • Be safe with medicines. Give pain medicines exactly as directed.
    • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
    • If your child is not taking a prescription pain medicine, ask your doctor if your child can take an over-the-counter medicine.
    • Do not give your child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
    • Do not give aspirin to anyone younger than 18. It has been linked to Reye syndrome, a serious illness.
  • If your doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.

When should you call for help?

Call your doctor or nurse call line now or seek immediate medical care if:

  • The skin near the wound is cool or pale or changes colour.
  • The wound starts to bleed, and blood soaks through the bandage. Oozing small amounts of blood is normal.
  • Your child has signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the toe or finger.
    • Pus draining from the toe or finger.
    • Swollen lymph nodes in the neck, armpits, or groin.
    • A fever.

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse call line if:

  • Your child has problems with the nail as it grows back.
  • Your child does not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Current as of: October 13, 2016