Letters to the Editor

Subungual Slivers May Be Treated Conservatively

to the editor: In the June 15, 2003, issue of American Family Physician, Drs. Chan and Salam discuss an operative technique for the removal of subungual slivers.1 I would like to suggest an alternative method, which is to treat the patient conservatively. If the physician cannot remove the sliver easily with an approach under the nail (i.e., using a hooked needle or forceps), the sliver may be left where it is. The patient should receive tetanus toxoid and antibiotics, if necessary. The sliver will gradually “grow” out with the nail and can be removed easily in 10 to 14 days.

In 20 years of using this technique, I have never seen a subsequent deformity or infection of the nail. The patient is happier with the results because he or she does not have a “split” nail while the débrided nail heals. The initial pain seems to clear rapidly and can be handled with analgesic medications.

Send letters to Kenny Lin, MD, Assistant Editor, American Family Physician, e-mail: afplet@aafp.org , or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, telephone number, and fax number. Letters should be fewer than 500 words and limited to six references (including citation of original article) and one table or figure.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.

Copyright © 2004 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.