Isla Bennett
Smashing your finger or toe can cause a subungual hematoma, which is when blood pools under the nail, causing throbbing pain and pressure. To relieve this, some people recommend drilling a small hole in the nail to drain the blood. This procedure, also known as trephination, should be done within 48 hours of the injury, as the blood will begin to clot after this time, making drainage difficult. While some people opt for a heated pin or needle, others suggest using a small drill bit and twisting it slowly by hand until the blood starts to flow out. This method is said to be less painful and reduces the risk of touching the nail bed. However, it is important to note that attempting to drain a hematoma at home may lead to infection, and it is always recommended to seek medical advice before proceeding with any treatment.
| Characteristics | Values |
|---|---|
| What | Draining a subungual hematoma (blood pocket under the fingernail) |
| Why | To relieve pain and pressure |
| When | Within the first 48 hours after injury, before the blood clots |
| Who | A doctor, or yourself at home |
| Tools | Drill bit, heated pin, hot paper clip, pocket knife, ice pick, pulsed YAG laser welder, etc. |
| Technique | Twist the drill bit slowly by hand into the nail until blood appears |
| Aftercare | Band-aid the area for a few days until the hole scabs over |
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What You'll Learn
Drainage must be performed within 48 hours of injury
A smashed nail can be extremely painful, and the pain can be unbearable even for those with high pain thresholds. The pain is caused by the pooling of blood under the nail bed's surface, known as a subungual hematoma. This is a common occurrence after stubbing or crushing injuries to the fingers or toes.
To relieve the pain and pressure, the hematoma can be drained. This procedure, called trephination, involves making a small hole in the nail to allow the blood to flow out. Drainage can be performed quickly and relatively painlessly in a doctor's office or urgent care center.
It is important to note that drainage must be performed within 48 hours of the injury. After this time, the blood begins to clot, making drainage difficult. If home measures such as elevating the hand or foot, using a cold compress, and applying compression do not provide relief, it is recommended to see a doctor within the first 48 hours to drain the hematoma.
Do not attempt to drain the hematoma at home as it may cause infection. The proper procedure for drainage involves cleaning the area, administering pain relief or anesthetic, creating a small hole in the nail, allowing the blood to flow out, and then covering the area with a dry bandage.
In some cases, the nail may need to be removed, and the nail bed repaired. Antibiotics may be prescribed to prevent infection, and it may take several months for a new nail to grow back.
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Fingernails don't have nerve endings
If you've smashed your finger, you may notice blood pooling under the nail, causing a subungual hematoma. This can be extremely painful, and the pressure of the blood can cause the nail to come off. To relieve the pain and pressure, you can drain the hematoma.
One method of draining the hematoma is by drilling a small hole into the nail to allow the blood to flow out. This procedure, also known as trephination, can be performed at a doctor's office or urgent care center. It is important to note that nail drainage should only be performed within the first 48 hours after the injury, as the blood begins to clot after this time frame, making drainage difficult.
While the area underneath the fingernails is sensitive, it is important to note that fingernails themselves do not have nerve endings. The skin underneath the fingernails is sensitive because the nerve endings in that region are exposed. The nail acts as a protective layer, and when it is removed, the skin underneath becomes more sensitive to touch and pain.
The fingertips are dense with nerve endings, and the exposed flesh beneath the fingernails does not have the same protective layers as the fingertips. The skin under the fingernails does not have a protective layer of almost dead cells, which helps to reduce the intensity of stimulation. Therefore, when the nail is removed, it gives direct access to the nerves beneath, resulting in a unique and intense pain.
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Drainage provides instant relief
A smashed fingernail or toenail can cause blood to pool under the nail bed's surface, resulting in a subungual hematoma. This condition can be extremely painful and may cause difficulty sleeping. To relieve the pain and pressure, drainage of the hematoma can be performed, providing instant relief.
Drainage of a subungual hematoma involves creating a small hole in the nail to allow the blood to flow out. This procedure, also known as trephination, can be performed quickly and with minimal pain in a medical setting. It is important to seek medical attention within the first 48 hours after the injury, as the blood begins to clot after this time frame, making drainage difficult.
Several methods can be used to drain a subungual hematoma. Some people use a heated pin or paper clip to create the hole, but these methods can be painful and may increase the risk of infection. A safer and less painful approach is to use a small drill bit, slowly twisting it by hand into the nail until the blood begins to flow out. This method allows for precise control and minimizes the risk of damaging the sensitive tissue underneath the nail.
It is important to note that attempting to drain a subungual hematoma at home carries risks, including infection and further damage. It is always advisable to consult a doctor or healthcare professional before attempting any drainage procedure. They can assess the severity of the hematoma and determine the most appropriate course of treatment. In some cases, small hematomas may resolve on their own without the need for drainage.
Overall, drainage of a subungual hematoma can provide instant relief from pain and pressure. However, it is important to seek medical advice and proceed with caution to ensure the procedure is performed safely and effectively.
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Do not use a power drill
Drilling a hole in a smashed fingernail or toenail is a method used to drain the blood accumulated underneath the nail, known as a subungual hematoma. This procedure, also called trephination, is typically performed at a doctor's office or urgent care centre. While some people opt to do this at home, it is important to emphasise that you should not use a power drill for this purpose.
Using a power drill to penetrate the nail can be extremely dangerous and cause more harm than good. The high speed and torque of a power drill can lead to loss of control, potentially damaging the underlying nail bed and sensitive tissue. This can result in severe pain, infection, and further complications.
Instead, if you choose to perform trephination at home, it is recommended to use a manual drill bit or other tools, such as a heated needle or pin. Even with these methods, there are risks of infection and additional injury, so it is always advisable to consult a medical professional before attempting any at-home procedures.
The proper way to use a manual drill bit is to slowly twist it by hand into the nail, away from the cuticle, until you penetrate the bottom of the nail. This allows the blood to drain out without putting excessive force on the nail bed. It is crucial to sterilise the drill bit or any other tool before use to minimise the risk of infection.
In conclusion, while drilling a hole in a smashed nail can provide relief from pain and pressure, it is important to refrain from using a power drill. The potential risks associated with a power drill outweigh the benefits, and it is always best to seek professional medical advice before attempting any at-home treatments.
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Home methods carry a risk of infection
Home methods of drilling a smashed nail carry a risk of infection. Draining a subungual hematoma (blood pooling under the nail bed's surface) can be done at home by drilling a hole into the nail to allow the blood to flow out. However, this can lead to infection if bacteria enter the wound. Doctors recommend that you do not attempt to drain your hematoma at home and instead seek medical attention.
The risk of infection from home methods is due to the use of unsterilized tools and improper techniques. Using a heated pin, paper clip, or drill bit to create a hole in the nail may introduce bacteria into the wound, leading to an infection. Infections can often cause more damage than the initial injury.
To reduce the risk of infection, it is essential to follow proper sterilization and cleaning procedures. The area around the injury should be cleaned with alcohol, iodine, or another antiseptic solution before any procedure. This helps kill bacteria and lowers the risk of infection. Additionally, using sterile tools, such as a sterile needle, can also reduce the chances of introducing bacteria into the wound.
Another risk factor for infection is delaying treatment. The blood begins to clot after 48 hours, making drainage more difficult. Therefore, it is recommended to see a doctor within the first 48 hours after the injury for the best results. Attempting to drain the hematoma at home after this time frame increases the risk of infection and other complications.
Furthermore, home methods may not effectively relieve the pain and pressure associated with a subungual hematoma. In some cases, improper drilling may penetrate the delicate nail bed, causing additional pain and damage. It is crucial to understand that fingernails and toenails do not have nerve endings, so any sensation of pain during drilling is an indication of potential damage to the underlying tissue.
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Frequently asked questions
A subungual hematoma is a blood pocket or bruising under the nail bed's surface, usually caused by a crushing or stubbing injury.
Doctors recommend draining subungual hematomas when they cause pain or make up 50% or more of the nail. If you've also fractured your finger, doctors recommend drainage if the hematoma makes up 25% or more of your nail.
You should visit a doctor within the first 48 hours after your injury for the best results. Nail drainage can only be performed within this timeframe as the blood begins to clot after this amount of time, making drainage difficult.
Drilling a hole in your nail to drain a subungual hematoma can lead to infection if bacteria enter the wound. It is recommended to visit a doctor or urgent care center to perform the procedure.
It is recommended to use a new, small drill bit or needle and twist it slowly by hand until you penetrate the bottom of the nail. Do not use a power drill or attempt to drill through the nail bed. Run the affected area under warm water to let the blood flow out.
