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How an Ingrown Toenail Caused a Leg Amputation

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Mr. Jones, a 67-year-old male, has history of type II non-insulin-dependent diabetes. He also has a history of kidney failure on dialysis and a severe circulation problem. He has years history of cigarette smoking. He presented to my office with a chronic ingrown toenail. He attempted to take care of the ingrown toenail by himself by trimming the ingrown portion of the nail, washing and cleaning with alcohol and peroxide. Eventually decided to come to my office.  When he presented in my office, his toe was already became cyanotic and blueish (Fig.1). In this case, attempts to save his leg by a podiatrist, vascular surgeon, infectious disease specialist, endocrinologist, the toe became gangrene, and he lost the big toe (Fig 2).  When a patient with an advanced circulation problem, it is difficult to heal even a minor toe amputation.  The toe amputation did not heal so half of his foot had to be amputated (Fig 3) to stop the spread of infection up the leg. Again, our attempts to save the leg failed, and he eventually ended up with a below-the-knee amputation (Fig 4). 

There are lessons to be learned here.  

  1. Even seemingly a minor problem such as an ingrown toenail,  diabetic people can lose the leg
  2. Do not attempt to treat the problem yourself.
  3. Smoking cigarette causes damages to the circulation even more. 

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