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My first toenail removal was amazingly easy. The patient had an infection under the nail and it was almost falling off by itself. I didn't really know the steps of the procedure but my attending walked me throug it and before I knew it I was shoving a hemostat under the nail and prying it up. After that all I had to do was pull and there it was. Thank goodness for my masterfull anesthesia skills, a good digital block is key to a good nail removal.