Would this injury make you worry about tetanus? (pics)

[luminesce]

My 3 yo pulled his small wooden desk chair over onto his toe on June 1st. It only caused him pain for about 10-15 minutes. No pain since -- but it looks ugly. At the time of injury (the first picture was taken right after he hurt it) it appeared that all the nail folds, etc were intact and given there was no pain or pressure from the hematoma, we didn't see the family doc. I don't know if there was a laceration in the nail bed or not though. It did, however, turn black the next day and I think it has only recently started to grow out. Where it is growing out, it looks like the nail bed is dipped down in and the cuticle seems to have separated. If I remember from my own finger injuries, I think the dip is pretty normal. I don't know, however, if because of the damage, he is at risk for tetanus. It appears to still be intact but I'm not sure what is going to happen at the base of the nail as it grows. I doubt he would lose the nail at this point if it hasn't come off in 3.5 weeks - but I dunno. Would you worry about tetanus? He is *always* barefoot but I've started putting a sock on that foot.


Time of injury: June 1st

3+ weeks later: June 24th

[mama2soren]

Ouch! Poor guy.

Tetanus is anarobic. It won't grow in a shallow wound. It needs a deep puncture wound, where it can grow without being exposed to oxygen.

[dakotablue]

oooh that looks yucky. I did the same thing when I was younger and it remember it looked just like that! I dropped a bowling ball (that I was told not to pick up) on my toe. If I recall correctly it didn't fall off and wasn't painful later. the old blood was black and there wasn't any further damage than the initial drop.

you picture looks good though it doesn't look infected around the toe bed.

[Lisa1970]

If I lived in a 3rd world country where Tetanus was known to exist and did not have access to clean water to wash it with, yes, I would worry about Tetanus. But in the rest of the world, I would wash it and put some neosporin on.

[Angela512]

Tetanus is a concern for people who get a very deep puncture wound (think long nail in the foot), where it does not bleed much. The bleeding actally cleanses the wound and, usually, if the wound is bleeding, it has a very, very low risk of getting tetanus. If it's a deep wound and not bleeding that is when tetanus usually happens.

So, I think your son's toe is completely fine...painful, but fine.

[littlemizflava]

i would have no fear about tetanus. when speaking of the fears of tetanus you would want the wound to bleed but that wound is just a bruse on the nail. that looks just like my ds's nail. he stuck it in a closing door. it will start to grow heathy nail in a while. it took 2 months before i could see healthy nail growing.

[luminesce]

BTW, to clarify my tetanus worry - I thought that "under the nail" was a good anerobic breeding ground. Maybe things could get in but it definitely can't breathe under there, etc. Also I have a scientific paper on tetanus that listed nail hematomas as causing three cases of tetanus - my guess is that they were much worse though, with big compromises in the nail bed, etc.

[bremen]

but where would the tetanus come from, and how would it get in?
tetanus spores are found outside, usually around livestock. his desk chair wouldn't usually have that.
there does not appear to be any skin puncture at all. how would the tetanus get into his body?
that toe injury looks like it hurts, but there does not appear to be any way for it to transmit tetanus

[luminesce]

Originally Posted by bremen

but where would the tetanus come from, and how would it get in?
tetanus spores are found outside, usually around livestock. his desk chair wouldn't usually have that.
there does not appear to be any skin puncture at all. how would the tetanus get into his body?
that toe injury looks like it hurts, but there does not appear to be any way for it to transmit tetanus

As I posted, everything was intact when injured and for the most part appears to still be that way but the cuticle looked like it might be starting to separate from the bed. I thought the toenail may lift up slowly and slightly if it falls off (as a new toenail grows and pushes it out.) I guess I was worried it would be open enough for germs to get in to open skin yet not really breathe well. It may just grow out though. In that case, I'm not worried at all.

We had horses here for years but that doesn't really concern me. Tetanus spores are ubiquitous.

[Magali]

I wouldn't worry about tetanus in this situation.

[mamaof5boys]

Originally Posted by bremen

but where would the tetanus come from, and how would it get in?
tetanus spores are found outside, usually around livestock. his desk chair wouldn't usually have that.
there does not appear to be any skin puncture at all. how would the tetanus get into his body?
that toe injury looks like it hurts, but there does not appear to be any way for it to transmit tetanus

I'm confused about this. I thought tetanus spores are everywhere- including our skin. So couldn't any injury potentially be a source for tetanus given the right conditions?

[INF-ss]

Yep, that will surely fall off to give way to the new nail--a clear indication not to worry about tetanus.