A subungual hematoma is a collection of blood in the space between the nailbed and fingernail. Subungual hematoma results from a direct injury to the fingernail. The pressure generated by this collection of blood under the nail causes intense pain.
Subungual Hematoma Causes
Subungual hematomas most commonly form after a crush-type injury to the tip of the finger or toe.
This injury can occur in many ways:
Hitting your finger with a hammer
Dropping a heavy object on your toe
Closing your finger in a door
Subungual Hematoma Symptoms
Blood underneath the nail of either a finger or toe is a subungual hematoma.
You will have a discoloration of red, maroon, or other dark color beneath the nail after an injury.
The most common symptom is intense pain.
Pressure generated between the nail and the nailbed, where the blood collects, causes this pain.
The pain may also be caused by other injuries such as a fracture (break) to the underlying bone, or bruising to the finger or toe itself.
Subungual Hematoma Treatment
Self-Care at Home
Ice, elevation (keeping your arm or leg above the level of your heart), and anti-inflammatory medications, such as ibuprofen (Advil, Motrin), are recommended for minor hematomas. Wrap ice in a towel and do not apply ice directly to skin. A bag of frozen vegetables wrapped in a towel works well.
If the hematoma involves more than 25% of the area of the nail, then medical attention is needed.
If the nail was removed by the injury or the doctor and the nailbed wasn't cut, the following home treatment is recommended until the nailbed begins to be less sensitive, usually in 7-10 days.
Twice daily soaks with antibacterial soap and water for 10-15 minutes
After soaks, application of a topical antibiotic ointment (such as Neosporin) and a dry sterile bandage (Band-Aid)
Medical Treatment
Several techniques are used to drain the blood beneath the nail. This procedure is also called releasing the hematoma.
No single technique is preferred.
How your hematoma is drained depends on the experience of the doctor and where it is done.
Frequently, the finger or toe is numbed with a digital block. (Your fingers and toes are called digits.)
A numbing medication such as lidocaine is injected at the bottom of your finger or toe.
Injecting the medication here numbs the entire digit.
As soon as your finger or toe is numb, the procedure can take place.
The following are commonly used methods for draining your hematoma:
Cautery: A battery-operated device is used to burn a hole in the nail until the blood is reached and drains out the hole.
Needle: A large diameter needle is used to drill or bore into the nail to create a hole to allow the blood to drain out.
Paper clip: This technique, although an older one, is still used by some practitioners. A paper clip is opened so that the pointed end is free. Then the pointed end is heated up, usually by passing it through a flame, and used to burn through the nail. This technique uses a combination of the cautery method and the needle method.
Prevention
Use common sense and practice other safety-minded actions to prevent getting your fingers slammed in doors or dropping heavy objects on your toes.
Steel-toed shoes are important safety equipment to wear on certain high-risk jobs such as construction.
Watch children's hands as you open and close car doors.
Give your full attention to the task at hand. Finger injuries often happen when the person using the tool is distracted.
Don't lift something you cannot handle alone. Find people to help you carry heavy objects to avoid dropping them on your toes.
Circulatory System
Circulatory System, or cardiovascular system, in humans, the combined function of the heart, blood, and blood vessels to transport oxygen and nutrients to organs and tissues throughout the body and carry away waste products. Among its vital functions, the circulatory system increases the flow of blood to meet increased energy demands during exercise and regulates body temperature.
