Brief Outline of Black Nail

A subungual haematoma is bleeding under the toenail caused by an injury or infection to the nail bed. Crushing injury is the most common mechanism for this type of injury. The bleeding under the nail causes pressure and pain to the nail bed. The pocket of blood maybe small or cover the whole area under the nail.

Anatomy and physiology

The nail protects the area under the toenail, the nail bed, but when crushing trauma, an object under the nail, or infection causes damage to this soft area, bleeding may occur. Because the nail is a hard surface, it holds the blood in and this bleeding causes pressure and pain. Depending on the initial injury, the bone underneath may also be involved.

Cause of injury

Crushing injury to the toe. Foreign object under the nail causing a laceration to the nail bed. Infection under the nail causing bleeding.

Signs and symptoms

Pain and pressure under the nail. Red, maroon or other dark colour under the nail.

black toenails

Complications if left untreated

The bleeding and resulting pressure under the nail may cause damage to the underlying tissues, killing them over time. The nail may fall off and this could lead to infection if not treated properly. If the bone was fractured during the initial injury, chronic pain may result.


Rest, ice and elevation. If the nail comes off, it is important to keep it covered and protected. If the possibility of a fracture exists, such as with a crushing injury, seek medical attention.

Rehabilitation and prevention

The nail may need to be removed during treatment, or may fall off on its own, leaving the nail bed exposed. It is important to keep this area protected to prevent infection. It is also important to protect the affected toe while it is healing. Padding over the toes may be needed. Avoiding impact to the toes and protecting them during activities will help prevent this injury.

Long-term prognosis

A subungual haematoma will usually respond well to treatment, although in cases involving more than 25% of the nail bed and pressure that is unrelieved by initial treatments, a physician may need to drain the blood from the nail bed. If an infection is the cause, oral or topical antibiotics may be required.

Call (+65) 64712 674 (24 Hour) to fix an appointment with our doctor to treat Black Toenail today.

Surgical Nail Removal Overview

You may want to consider surgical nail removal for severe or recurrent fungal nail infections. The whole nail or only a portion of the nail can be removed surgically.

Surgical nail removal can be done at the clinic. The orthopaedic surgeon will give an injection in the finger or toe for local anaesthesia. He will then start by loosen the skin around the nail and then tries to separate the nail from the skin by using a tool under the nail. If a portion of the nail is infected, only the affected nail is removed.

Our orthopaedic surgeon can remove the root of the nail to prevent the nail from growing back if you have recurrent nail infection that does not seems to go away with conservative treatment.

Your finger or toe will be covered with gauze and tape once the surgery is done.

What to Expect After the Surgical Nail Removal

For the first few weeks after the surgery, keep the wound dry and clean. The wound should heal very well after a few weeks.

Is it Necessary to Have My Nail Surgically Removed?

Surgical nail removal is performed when a large portion of the nail is infected and damaged or the nail is causing you extreme pain. Majority of the cases only requires to remove a portion of the affected nail.

How Well Does Surgical Nail Removal Works?

After the infected nail has been removed, the infection can be further treated by taking oral anti-fungal medicine.

What are the Risks Involved in Surgical Nail Removal?

The risk is very small. It could be:

  • Pain.
  • Infection.
  • Nail grows abnormally.

What to Think About for Surgical Nail Removal?

If you have been having recurrent nail infection, you can choose to have the nail removed together with its root. Once the root of the nail is removed, there is no chance for the infected nail to grow back again.

Call +65 64712674 for an appointment to see our orthopaedic surgeon to treat your infected nail today.

Ingrown Toe Nail

What is Ingrown Toe Nail?

Ingrown Toe Nail
Ingrown Toe Nail

An ingrown toe nail is a painful condition of the toe. It occurs when a sharp corner of the toenail digs into the skin at the end or side of the toe. Pain and inflammation at the spot where the nail curls into the skin occurs first. The inflamed area then starts to grow extra tissue or drain yellowish fluid.

What are the Causes?

Ingrown toe nail can be caused by tight-fitting shoes or high heels causing the toes to be compressed together and pressurize the nail to grow abnormally. Improper trimming of toenails can also cause the corners of the nail to dig into the skin. Disorders such as fungal infections of the nail can also cause a thickened or widened toenail to develop.

How to Prevent Ingrown Toe Nail?

The best method of prevention is careful clipping of the toenails. Toenails should be clipped straight across and taking care to keep the end longer than the skin edge. This prevents the corners from digging into the skin. They should not be rounded or cut too short. Wearing well-fitting shoes helps as well.

What are the Treatments?

Post Ingrown Toe Nail
Post Ingrown Toe Nail

Mild ingrown toenails may be treated with conservative measures like warm daily soaks, topical antibiotics, and gently pushing back the piece of overgrown skin away from the nail. More advanced ingrown toenails may require treatment with oral antibiotics. Resistant or recurrent cases of ingrown toenails may require a minor in-office procedure. Surgical procedures aim to remove the embedded nail from the toe tissue.