Training accident / did i do the right thing

[robblok]

I got a few questions regarding an accident i had yesterday and the operation i took because i might or might have been scared in having one.

I was doing some exercises with a belt with a 25kg and 10kg plate attached. The leather tore open (its made for this it should not but did) and the 25 kg disk of weight got on my big too. It caused a wound a bit above my nail and broke the bone at the tip of my toe.

At first i thought nothing of it (hurts like hell) and thought i stay home but my gf told me to go to the hospital and let them drill holes in the nail. Once i was there they took xrays told me i needed an operation as i had a high risk of infection and else i might have to amputate later on.

I as a foreigner questioned this (dr spoke good english) as the wound was far from the broken toe and the wound bleeded so infection stuff would have been pushed out. The problem was not the operation 20k (im insured) but the fact they wanted to keep me 2 days in the hospital as i needed injections of antibiotics every 6 hours. I thought it was overkill but managed to get them to let me go and i go there now every 6 hours for 2 days to get shots.

In the end they took of the nail.. and cleaned the bone (wound was under the nail so not the cut above the toe). Then because it kept bleeding sewed the nail back on. (it hurts a lot). I really don't mind the operation but wonder if it was needed. Of course the antibiotics are a drag but i am going to go there for the remainder. I just wonder if this is not huge overkill.

Cant wait for this to get better as its painful but the nail will take a while just wonder when the pain will go.

Good thing i did not buy the belt in thailand or id be complaining about thai quality... but this was... xxxxxxxx farang quality.

[robblok]

The belt that caused me all this grief.

[Sheryl]

Without having seen the wound and the Xrays, no one is going to be able to tell you if the treatment given was appropriate/ necessary.

Would also need more information as to just what this "operation" was.

[Crossy]

Ouch!

Thanks for NOT posting an image of your toe Rob, made me cringe just reading about it.

Actually do post an image if you can, might help those in the know to assist.

I had a similar injury years back (not from training, on a building site, yes, I was wearing toecaps), hurt like @#$% for several days despite painkillers, hurt a lot for weeks, the nail is still not right although no op needed.

Hope it gets better rapidly.

[h90]

2 shots antibiotics every 6 hours? Are you serious?

1 ) as lot bleeding, and just the weight, not something dangerous=no antibiotics

2 ) If than just some oral one, no need to inject.

Normally if the joint isn't damage a toe heal on itself. But a big warning....walking around with it and crashing it in the leg of a chair or something similar gives you an experience you won't forget....I tried that already.

Best is to tape it to the next toe....but with the big toe it is a bit difficult.

And you'll live a few days without shoes I think....

[h90]

Ouch!

Thanks for NOT posting an image of your toe Rob, made me cringe just reading about it.

Actually do post an image if you can, might help those in the know to assist.

I had a similar injury years back (not from training, on a building site, yes, I was wearing toecaps), hurt like @#$% for several days despite painkillers, hurt a lot for weeks, the nail is still not right although no op needed.

Hope it gets better rapidly.

When I scrolled down and saw the picture I hardened myself already for the bloody mess.....but it was just the belt.....

Maybe a spontaneous: make a forum, only for adults with extra password....open at own risk....There could be all the car accident photos, the postings about the not so nice dialog with the katoy girlfriend, a poll about the new tattoo on the xxxxx and the worst...robblocks bloody toe....

[FBN]

Any fracture with an associated open wound, especially this traumatic, is regarded as an open fracture and the risk of infection is high. Cleaning the wound, can usually be accomplished with a local analgesic block and the nail, if there is a collection of blood under it, should be drilled to drain the blood and relieve pressure. The nail is usually left in place to serve as a splint for the underlying fracture. It is the only way you can actually splint a fracture of the last bone in any digit. Antibiotics will usually depend on the severity of the wound.

At home, frequent dressings with wound cleaning with an appropriate antiseptic (Betadine of Chlorexidine;at least 2x per day) wil be more effective in keeping infection at bay than antibiotics although antibiotics are frequently given as said before initially.

This takes a long time to heal and may remain painful for a long time; especially for jogging..

[Shurup]

Ouch! I better check my belt, even though I don't use it often.

Without seeing pictures of the wound I wouldn't even guess if the antibiotics were needed, but it does sound like overkill, and I do remember reading how Thai docs like prescribing them for everything...

Was it right or left foot? Would be hard to shift your bike's gears if it's left!

[robblok]

Any fracture with an associated open wound, especially this traumatic, is regarded as an open fracture and the risk of infection is high. Cleaning the wound, can usually be accomplished with a local analgesic block and the nail, if there is a collection of blood under it, should be drilled to drain the blood and relieve pressure. The nail is usually left in place to serve as a splint for the underlying fracture. It is the only way you can actually splint a fracture of the last bone in any digit. Antibiotics will usually depend on the severity of the wound.

At home, frequent dressings with wound cleaning with an appropriate antiseptic (Betadine of Chlorexidine;at least 2x per day) wil be more effective in keeping infection at bay than antibiotics although antibiotics are frequently given as said before initially.

This takes a long time to heal and may remain painful for a long time; especially for jogging..

Hi,

I will just get the antibiotics. been on my 3trd shot. I had my dressing cleaned at the hospitol.

But to be honest the original wound was not severe at all.. just a cut that bled a lot.

[robblok]

Ok operation was this, they cut the nail off and cleaned the bone (it was under the nail) and then put the nail back to stop the bleeding. To be honest, I am ok with this but they wanted to keep me in the hospital for 2 days. I would be bored out of my head and I had work to do. So now every 6 hours i make the 15 minute trip to the hospital. To get a shot of antibiotics. I also got antibiotic pills.

For me it sounds like a bit of overkill.

I hope it wont be painful for long.. i mean standing on it lifting weight (should not be painful i hope) i do no running or jogging ever. (maybe if i need to chase a pretty girl)

[h90]

ahh I misread it first, I thought you took of the nail and cleaned it yourself....

[robblok]

ahh I misread it first, I thought you took of the nail and cleaned it yourself....

No.. I am not stalone in first blood sewing himself up.. I can take a bit of pain.. but nothing like that.

[Tywais]

I had a similar injury but to my index finger tip rather than a toe. I walked out of an office and the door is on a hydraulic closer and slid my hand along the door to stop it from hitting me. My hand slid along the door and my finger got caught in the door hinge point. Heard a crunching sound and felt odd that my arm was still behind me like someone was holding it. Saw the issue and rushed to push the door open and grabbed my finger in my other hand and rushed to the first aid kit, blood streaming on the floor, and wrapped it in tissue.

Had someone take me to the hospital and xrays showed the bone in the finger tip was crushed. The nail was most of the way off and the finger tip split open from the end down the middle under the nail. The doctor injected the finger at the base with a nerve block and that hurt 10 times more than the actual finger injury. He used a scalpel to remove most of the nail down to the nail bed, thoroughly cleaned it and sutured the split closed. He then put on a metal finger splint but not really a splint but a protective shield like below. Tapped it thoroughly and gave pain meds and perhaps antibiotics, not sure of the latter. No real surgery involved except cutting the nail off.

Would guess the toe could be more sensitive to infection due to contact with the floor and associated dirt.

[h90]

ahh I misread it first, I thought you took of the nail and cleaned it yourself....

No.. I am not stalone in first blood sewing himself up.. I can take a bit of pain.. but nothing like that.

And I already admired you.......small things I can do but clean the bone no....

[Kalbo]

Hiya Rob, That injury looks painful. Only thinking about having one of those plates fall on my toe made my testicles start running around in my chest !

Hope the pain goes away soon.Cheers

[richard_smith237]

Jack Daniels famously died 5 years after breaking his toe when kicking his safe in frustration...

Are we going to start posting gory photos of our injuries ???

I've some shockers, missing toe nails etc after being studded while playing football....

Rob: get a 2nd opinion, but infection is a very real and ever present risk...

Edited January 29, 2014 by richard_smith237

[robblok]

Jack Daniels famously died 5 years after breaking his toe when kicking his safe in frustration...

Are we going to start posting gory photos of our injuries ???

I've some shockers, missing toe nails etc after being studded while playing football....

Rob: get a 2nd opinion, but infection is a very real and ever present risk...

Richard,

Let the mods take away the picture.. sheryl asked about the injury to make a call so i put it up. I understand your concern.

I am taking the antibiotics. It is no longer a question of not taking them.

I was only wondering if it was overkill. But i started on it and its 2 days of an injection every 6 hours so just 5 more injections and ill be done.

[richard_smith237]

Jack Daniels famously died 5 years after breaking his toe when kicking his safe in frustration...

Are we going to start posting gory photos of our injuries ???

I've some shockers, missing toe nails etc after being studded while playing football....

Rob: get a 2nd opinion, but infection is a very real and ever present risk...

Richard,

Let the mods take away the picture.. sheryl asked about the injury to make a call so i put it up. I understand your concern.

I am taking the antibiotics. It is no longer a question of not taking them.

I was only wondering if it was overkill. But i started on it and its 2 days of an injection every 6 hours so just 5 more injections and ill be done.

Leave the photo...

Nothing wrong with a few gory war wounds!

I sometimes have to google photos to place a perspective on how minor or serious (mostly minor 'cos I'm a bit of a girl) my injuries are...

You might get a few TV members sponsoring you for a pedicure !

Edited January 29, 2014 by richard_smith237

[h90]

Hiya Rob, That injury looks painful. Only thinking about having one of those plates fall on my toe made my testicles start running around in my chest !

Hope the pain goes away soon.Cheers

I guess Rob is happy that it was his toe and not his testicles....

[Sheryl]

Ok operation was this, they cut the nail off and cleaned the bone (it was under the nail) and then put the nail back to stop the bleeding. To be honest, I am ok with this but they wanted to keep me in the hospital for 2 days. I would be bored out of my head and I had work to do. So now every 6 hours i make the 15 minute trip to the hospital. To get a shot of antibiotics. I also got antibiotic pills.

For me it sounds like a bit of overkill.

I hope it wont be painful for long.. i mean standing on it lifting weight (should not be painful i hope) i do no running or jogging ever. (maybe if i need to chase a pretty girl)

From what you describe, 2 days in the hospital would certainly have been unnecessary. And IV antibiotics seems like overkill, would think oral would have sufficed along with wound care. Which hospital was this?

[robblok]

kasemrad near Bangyai been there before. They really were intent on keeping me there and letting me pay for a room. They liked that i had insurance.

Maybe im just a bit bias but i always do feel thais over prescribe ans want to operate or do more as in the Netherlands

Sent from my GT-I9300 using Thaivisa Connect Thailand mobile app

[Sheryl]

Small private hospitals like this are often the worst offenders in this regard. I'd suggest going elsewhere in future.

[robblok]

Small private hospitals like this are often the worst offenders in this regard. I'd suggest going elsewhere in future.

Thanks, i thought it was overkill. I am still going there every 6 hours to get my shot (1 more to go) and then done. Its a bore and my insurance wont pay for that as its outpatient. I would have been better of financially to be inpatient for 2 days. But really those 4000 baht are worth it NOT staying locked up in a hospital for 48 hours.

Its a bit ironic as my insurance company would have had to pay more if i choose to stay in the hospital and now that i go for a cheaper option they don't have to pay at all. But i knew this when i started it.

As i said before its not about the money.. just would not like being locked up there for 48 hours.

[Crossy]

Nice composition there Rob, could have got a better shot of the nurse mind. Wanna move it to photography?

For some reason my left big toe is now smarting (it's the one I injured), sympathetic pain?

[robblok]

Nice composition there Rob, could have got a better shot of the nurse mind. Wanna move it to photography?

For some reason my left big toe is now smarting (it's the one I injured), sympathetic pain?

Crossy, gf took the picture.. i prefer to look away when they are working on it. I don't feel it but for some strange reason i think that if i look i will feel hurt.. yea its dumb.

Anyway 1 more shot and then I dont have to go to the hospital every 6 hours. The 6am visit is the worst.

[h90]

Nice composition there Rob, could have got a better shot of the nurse mind. Wanna move it to photography?

For some reason my left big toe is now smarting (it's the one I injured), sympathetic pain?

Crossy, gf took the picture.. i prefer to look away when they are working on it. I don't feel it but for some strange reason i think that if i look i will feel hurt.. yea its dumb.

Anyway 1 more shot and then I dont have to go to the hospital every 6 hours. The 6am visit is the worst.

Yes Crossy is right.....We don't want to see your toe we want to see the nurse

[robblok]

Nice composition there Rob, could have got a better shot of the nurse mind. Wanna move it to photography?

For some reason my left big toe is now smarting (it's the one I injured), sympathetic pain?

Crossy, gf took the picture.. i prefer to look away when they are working on it. I don't feel it but for some strange reason i think that if i look i will feel hurt.. yea its dumb.

Anyway 1 more shot and then I dont have to go to the hospital every 6 hours. The 6am visit is the worst.

Yes Crossy is right.....We don't want to see your toe we want to see the nurse

I agree.. the nurse was cuter as my foot.

Anyway a few days now since the accident and I have been deadlifting already and it seems i can exercise as no pressure is put on my toe.

I don't like the fact that i cant go out easy (cant fit my feet in a shoe). I wonder how long i need to keep the splint on my toe as healing seems to go quite ok. I understand its a protection as my nail has been removed (and put back). This could be a long drawn out process. I just wonder how long before it does not hurt.

[FBN]

How long it will remain painful really depends on the damage to the bone itself. If you have a copy of the X-ray post it.

Shattered bone takes longer to heal and the closer to the joint, the longer it will take and more chance of chronic pain in there especially if the joint itself is involved.

[robblok]

How long it will remain painful really depends on the damage to the bone itself. If you have a copy of the X-ray post it.

Shattered bone takes longer to heal and the closer to the joint, the longer it will take and more chance of chronic pain in there especially if the joint itself is involved.

Hi,

To be honest I am not in pain at all, i wish i had a copy of the x ray I would have posted it. It was just a bit of problem at the top of the toe.

I don't feel a thing right now but I have a metal splint around it i think its against bumping into things. I will ask the Dr on the next appointment as when the splint is off i still have no problems.

With pain i mean more that i fear pain the moment i try to put on some shoes or something (haven't tried that yet and wont for a while) I would only be able to do that without the splint anyway.

I am not taking any painkillers now just antibiotics that i have been given. The nail has been cut off but put back (as a protection and to cover the wound under the nail) The wound / cut at the top of the toe (just damaged skin no bone problems there) has stopped bleeding and is healing.

There is actually no blood or anything anymore when we change the bandage.

I could still bend my toe and such at the night of the accident that is why i thought nothing was broken. Now I cant bend it (splint) but am pretty sure i can without it.

Edited February 2, 2014 by robblok

[tropo]

Jack Daniels famously died 5 years after breaking his toe when kicking his safe in frustration...

Are we going to start posting gory photos of our injuries ???

I've some shockers, missing toe nails etc after being studded while playing football....

Rob: get a 2nd opinion, but infection is a very real and ever present risk...

Richard,

Let the mods take away the picture.. sheryl asked about the injury to make a call so i put it up. I understand your concern.

I am taking the antibiotics. It is no longer a question of not taking them.

I was only wondering if it was overkill. But i started on it and its 2 days of an injection every 6 hours so just 5 more injections and ill be done.

I'm 100% certain it's overkill, but that's really what doctors must do to protect themselves legally. People have died from ingrown toenail infections. I suppose the nails are a dirty area of the body as they tend to catch a lot of dirt... and circulation in the feet is not the best in many people, so the risk of infection is fairly high.

It's killing a mosquito with a sledgehammer.... but I can see it from the doctor's perspective. They don't know how good you are at home care and don't want to risk it.

It's hard to believe anyone survived before antibiotics were discovered. How many of us would have made it to our present age without them? I know I would have expired long ago.