Ingrown Toenail. In later years the toenails may become hardened, thickened, and sometimes very irregular. This, however, does not constitute an ingrown toenail. The ingrown process occurs only after the nail has been trimmed back too far, and then grows forward against the skin in front of it. The nail grows into this skin much as a needle would, and the penetration of skin in a contaminated region like the toe, often results in a painful infection, accompanied by pus formation and bleeding.

Ingrown toenails can be prevented by allowing the end of the toenail to grow beyond the end of the toe. Once a toenail has been cut too short, and it starts growing into the skin in front of it, the nail must be mechanically elevated from the skin, by cotton packing or other measures. These relief measures are undertaken frequently in an infected area, and should be attempted only by physicians or foot specialists trained in the treatment of ingrown toenails.

Hip Fractures. One of the unfortunate calamities of later years is fracture of the hip, incurred through accidental falls. The

BROKEN HIP

Fig. 144. The broken hip is the most feared fracture of later years. This is because of the brittleness of the bone and the fact that most falls are onto the hip area.

Fig. 145. Surgical repair of a broken hip is effective with the use of a “nail” pinning the bone together across the fracture line. This is a most satisfactory treatment in an otherwise very difficult fracture.

hip can be broken at any age, but is more liable to occur during later years when the bones become weaker. Youthful bones are tough and strong; they bend slightly and are hard to break. In age, however, the bones acquire a glass-like brittleness and shatter easily. The hip joint’s outer position makes it absorb considerable punishment in falls, and is therefore, a likely spot for a fracture. A broken bone at this site of course, means the entire leg is useless, since its sole body support must come through the hip joint itself.

Hip fractures can be nearly painless if the broken bones are rammed together and held impacted in a correct position. However, the usual broken hip renders the patient entirely helpless, because the bones are separated and there is severe pain in any kind of motion.

Treatment of a fractured hip, as in any fracture, requires the broken bones to be put together and held in place. There are several ways of doing this, but the most desired method today is nailing the bone fragments together. To do this, a special nail is driven down the inside of the bone through the bone marrow and through the line of fracture, threading the bone fragments together. This treatment has allowed many patients considerable relief of pain with early leg motion, and quicker return to normal activity. It must, of course, be undertaken by a physician with experience in repairing fractures.