Fingernail avulsion with phenolisation

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Hi guys,

Just had in my clinic, a 35 yo male patient with learning difficulties, who has a ingrowing distal fingernail.
Ive never done a finger nail before, ive done over 2000 nail ops but not a finger. Is the process the same ? ive been looking online and theres little or no info on this procedure.
do i inject at the base of the finger and phenolise as normal

Any advice would be greatly appriciatted.

many thanks

Indie Sagar
Chorleychiropodypractice.co.uk

 

Are you legally covered to do this as a podiatrist? I wouldn't be so sure of it.

would a referral to his gp not much more appropriate

regards

ben

 

Are you legally covered to do this as a podiatrist? I wouldn't be so sure of it.

would a referral to his gp not much more appropriate

regards

ben

 

my understanding is that you may perform on the hands those procedures that you are able to perform on the feet such as wart destruction and nail procedures etc. whether you would wish to phenolise a finger nail is another matter. in accident and emergency departments they have been known to remove the finger nail and trim it and then replace i have been told by the A&E consultant i worked with. i became annoyed when a junior doctor tried this procedure on a toe nail which did not work.
that was the explanation i got from his consultant when i wrote a letter of complaint to him

 

If it is in your scope of practice, you perform the procedure on the finger nail as you would a toe nail.

Steven

 

My lady did hundreds, mainly for the burns unit, before the patient went into their pressure suit. The procedure is the same. In my day - about a million years ago, the legal situation was straightforward - if the procedure is the same as a pedal one then cover is ok. Rob

 

Yes I've done a few. No real difference in the procedure however I have never performed the procedure other than in theatre and with antibiotic cover. Dialysis patients do have finger nails that need rapid removal due to fluctuating oedema levels and are a portal of entry for nasty infections, you don't always need to do matrix phenolisation they frequently will settle without. I would say however with really high risk patients I used to opt for a total removal not partial as no incision was needed. Just a few thoughts to consider.