Subungal Hematoma

Courtesy: Prof Nabile Ebraheim, University of Toledo, Ohio, USA

SUBUNGUAL HEMATOMA

• A subungual hematoma is a collection of blood that occurs underneath a fingernail or
  toenail.
• There will be throbbing pain caused by the collection of blood underneath the nail.
• When injury is severe, the subungual hematoma is associated with a nail bed injury and a
  fracture.
• This injury is often the result of stubbing a toe, hitting the finger with a hammer, or by
  having a finger slammed by a car door.
• Trauma to the nail may cause bleeding into the
  constricted area underneath the nail.

TREATMENT

• Small hematoma: nail plate is usually intact. Relieve the pain by nail plate proliferation using
  a sterile needle or heated instrument. Hematoma is drained.
• Large hematoma: If more than 50% remove the nail plate and repair the nail bed. Look for
  nail bed laceration and repair it. Suture the nail bed.