Table of Contents
Subungual hematomas should be trephinated if they are acute (less than 24 to 48 hours old), are not spontaneously draining, are associated with intact nail folds, or are painful. After 48 hours, most subungual hematomas have clotted and trephination is typically not effective.
What happens if you don’t drain subungual hematoma?
If left untreated, a simple subungual hematoma typically grows out along with the lengthening nail plate and resolves on its own. Until the nail grows out, however, you can expect weeks to months of blue-black discoloration.
How long do you have to drain a subungual hematoma before it is too late?
The key is to ensure that the hematoma is not older than 48 hours. In most cases, the hematoma can be drained with a large needle without any complications. Follow up of patients is recommended to ensure that there is no infection and the hematoma has resolved.
Should I go to the ER for subungual hematoma?
Any severe blow to a finger or toe should be checked by your healthcare provider. You may have broken bones (fractures) or damage to other tissues. If you can’t see your healthcare provider right away, go to the nearest emergency department.
What happens if you leave blood under your nail?
Initially the injury may only hurt. The nail may feel sore or tender to the touch. As the blood pools under the nail the pressure from the blood can cause severe pain. The pressure caused by blood underneath the nail may result in the affected nail lifting off the finger or toe.
When should I see a doctor for subungual hematoma?
If a subungual hematoma is small and the pain is mild, it will usually resolve without treatment or complications. However, if there is severe damage to the nail bed, or if the pain is unmanageable, a person should seek medical treatment.
Should I drill a hole in my fingernail?
So, the best thing to do is drain the blood pocket under the nail and relieve the pressure build-up. Fingernails don’t have nerve endings, and by moving very slowly with a drill bit, you can reach the blood pocket without touching your nail bed!.
How do you treat subungual hematoma at home?
Many subungual hematomas can be cared for at home. To reduce swelling, the AOCD recommends elevating the affected hand or foot and icing the area. To do this, wrap ice in a cloth or towel, or create your own cold compress. Applying ice to skin directly can cause damage.
How do I release pressure under my nail?
Straighten a paper clip, and heat the tip in a flame until it is red-hot. Place the tip of the paper clip on the nail and let it melt through. There are no nerves in a nail, so putting a hot paper clip on a nail should not hurt. Do not push or apply pressure on the paper clip.
What helps subungual hematoma?
A small subungual hematoma may not need medical treatment. Ice and elevate the area to reduce swelling, and take over-the-counter anti-inflammatories like aspirin, Advil, or Motrin for minor pain. But the pressure generated by pooled blood under the nail can be extremely painful.
Is hydrogen peroxide good for subungual hematoma?
The alkaline solution of hydrogen peroxide can be used for emergency discoloration subungual hematoma, the skin in the area of bruise and the bandage stained with blood.
How do I know if my nail bed is damaged?
A person should see a doctor if: any jewelry is difficult to remove from the injured finger or toe. pooling blood covers more than half of the nail bed. pain from the injury is severe. bleeding does not easily stop. any cut is deep. the nail is cut, torn, or detached from the nail bed. the finger or toe has an usual shape.
Does draining a subungual hematoma hurt?
Drainage of a subungual hematoma is often accomplished with use of an electrocautery device or heated 18-gauge needle. However, this procedure can be very painful, requires local anesthetic and a heat source, and creates a small hole which can be easily clogged.
Should I drain blood from under nail?
You may be able to relieve severe, throbbing pain by draining blood from under your nail. This procedure is not necessary and is not recommended if you are not having pain. This procedure is safe if done properly.
Will a subungual hematoma drain on its own?
Subungual hematomas should be trephinated if they are acute (less than 24 to 48 hours old), are not spontaneously draining, are associated with intact nail folds, or are painful. After 48 hours, most subungual hematomas have clotted and trephination is typically not effective.
Why is my hematoma hard?
Many injuries can develop a hematoma and give the area a firm, lumpy appearance. If you have an injury, you might have more than a bruise. It’s important to see your doctor if your bruise swells or becomes a firm lump, because it might mean something more severe happened under the skin.
Does nail trephination hurt?
Reassure the patient that trephination takes only a few seconds and is almost painless—much less so than a digital block. If the patient cannot be reassured, anesthetize the distal finger with a digital block.
Does nail pitting go away?
Treatment of nail pitting and other nail issues is often a long-term process. In some cases, this treatment isn’t always effective. It’s important that you try to avoid triggers that make nail pitting worse. This includes trauma to your hands and feet.
