Two and a half weeks ago I had my big toe hit by a bookcase. X-ray showed that bone was not fractured and I don't see any problems with nail itself (nail bad is stained with blood though).
However I'm concerned about proximal nail fold area which received most of the impact, and it changed a lot after this accident. Surface of the skin is not damaged at all and cuticle looks ok, but between nail fold skin and nail there seems to be only a thin layer of dark red coloured dry blood, so the whole area, half moon shaped (max. width in the middle 5 mm), is much thinner than compared to a healthy toe. It was also bleeding here a little bit for about a week, so I punctured a small hole with a needle so this blood would flow out. I'm afraid that nail fold cells were crushed, and what then? Will it regenerate after some time? Or should I maybe have some surgery to implant new skin...I'm concerned because I know that cuticle grows from this skin and also it keeps the whole nail stable and healthy.
Did anyone had injury in this area, or know anything that could clear my thoughts? I would be really thankful.
Whenever the nail root is compromised, it will stop producing proper nail plate cells until it heals. When it does begin to produce nail palte cells, they may be very wavy from lateral fold to lateral fold. The damage may be localized to the proximal nail fold area, or it may grow out with the nail plate. YOu wll not know until the nail has replaced itself in its entirety, which can take up to a year because toenails grow much slower than fingernails.
There is no way to have skin grafted to a nail bed. If so, a new nail will not attach to the skin since there are no rails on the surface of 'real' skin for the nail plate to attach to.
As I understand you say that there is no way to tell about nail matrix condition, until it regrows nail. But what about a visible part of proximal nail fold tissue? I guess it grows from surrounding skin, right? What would happen if only this part, which is on top of forming nail, would be mechanicaly injured? I'm asking because maybe there is a treatment needed to regrow skin, or maybe it does not need any treatment, as it will restore itself. For now I see that in this moon shaped area, between nail and undamaged skin surface where there is no circulation, only blood clot formed. Also this are is now thinner than on the other toe.
The skin will heal just like the rest of your skin - it doesn't matter where it is on your body - it will heal. The matrix will continue to produce new nail plate cells which will push the damaged portion off the free edge. The matrix is very deep under the tissue and unless it is surgically removed, will always produce nail plate cells.