Isla Bennett
Nail injuries are common and can occur due to various reasons, such as smashing a finger in a door, hitting it with a hammer, or cutting it with a sharp object. Treatment for nail injuries depends on the type and severity of the injury. Minor injuries, such as small subungual hematomas (nail bruises), can often be treated at home with proper wound care and pain management. However, more severe injuries, such as deep cuts, lacerations, or fractures, may require medical attention and even emergency care. In some cases, the nail may need to be removed, and the nail bed may need to be repaired. The recovery time for nail injuries varies, with nail bed injuries typically taking 7 to 10 days to heal and new fingernails taking 4 to 6 months to grow back completely.
| Characteristics | Values |
|---|---|
| Type of injury | Nail injury, nail bed injury, subungual hematoma, nail avulsion, distal tuft fracture, laceration, amputation, hook nail, split nail |
| Cause of injury | Smashing finger in a door, hitting with a hammer or other heavy object, cutting with a knife or sharp object, bite wounds, stepping on a nail |
| Treatment | Depends on the type and seriousness of the injury; home care, urgent care, or emergency room visit |
| Home care | Wash minor cuts or scrapes with soap and water, apply a bandage, use ice, keep hand or foot elevated, take pain medication |
| Urgent care | Doctor's examination, X-ray, anesthesia, removal of nail, stitches, special glue, antibiotics, splint, wire |
| Recovery time | Nail bed healing time: 7-10 days; new fingernail growth: 4-6 months; toenail growth: 12 months |
| Complications | Infection, deformity, poor healing, increased risk of infection in individuals with diabetes, poor circulation, AIDS, chemotherapy |
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Home treatment
If you sustain a nail cut injury, the treatment will depend on the type and seriousness of the injury. Home treatment may be appropriate if there is only a subungual hematoma (nail bruise) that occupies less than 25% of the total nail, and there are no lacerations or avulsions of the nail.
- Remove all jewellery from your hand. Apply soap, if necessary, to help rings slip off your fingers. If you cannot remove a ring because your finger is swollen, seek medical advice.
- Gently wash any minor cuts or scrapes with soap and water, then apply a bandage if needed.
- Keep your hand or foot elevated above the level of your heart to help with throbbing.
- Apply ice (inside a cloth) for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that.
- Take acetaminophen (Tylenol) or ibuprofen (Advil) for pain if you are not allergic to these medications.
If the injury is more severe, such as a deep cut in the nail bed or a large nail bruise, you should seek medical attention. Additionally, if you experience any signs of infection, such as redness or drainage at the site of the injury, it is important to consult a healthcare provider.
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Hospital treatment
If the bone under the nail is broken or the bruise is very large, the nail may need to be removed and the nail bed repaired. The doctor will create a small hole in the nail to drain blood and relieve pressure and pain. The nail will be reattached with a special glue or stitches. If the nail cannot be reattached, your doctor may replace it with a special type of material.
If you have a broken bone, your provider may need to place a wire in your finger to keep the bone in place. You may be given a splint or special shoe to help protect your nail and finger or toe as they heal. Antibiotics may be prescribed to prevent infection.
If the cut is deep, stitches may be needed. If the wound is bleeding severely, call 911 or your local emergency number.
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Nail removal
A nail injury can occur when any part of your nail becomes injured, including the nail, nail bed, cuticle, and the skin around the nail. A nail avulsion occurs when a portion of the nail is lifted off the nail bed or is sticking out of the skin at the base of the nail. This is often associated with a laceration or cut. If the cut is serious, your nail might have to be removed.
If you have a nail injury, you may be able to care for it at home if you can stop the bleeding quickly, and the nail is not cut or torn and is still attached to the nail bed. You should gently wash any minor cuts or scrapes and apply a bandage if needed. For more serious nail injuries, you should go to an urgent care center or the emergency room.
If you lose your nail, it will take about 7 to 10 days for the nail bed to heal. A new fingernail will take about 4 to 6 months to grow to replace the lost nail, while toenails take about 12 months to grow back. The new nail will probably have grooves or ridges and be somewhat misshapen, and this may be permanent.
If you have an artificial nail, it should stay in place until your nail bed heals. If your provider recommends it, change the dressing daily. If your provider says it is okay, you can apply a small amount of antibiotic ointment to keep the dressing from sticking.
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Nail bed injuries
A nail injury occurs when any part of the nail becomes injured, including the nail, nail bed (skin underneath the nail), cuticle (base of the nail), and the skin around the sides of the nail. Nail bed injuries are common, with fingertip injuries being the most commonly seen hand injuries. The most common causes of nail bed injuries are crushing injuries, such as getting your finger caught in a door or being hit with a hammer. Knives, saws, drills, moving belts, and lawnmowers are also common causes of nail bed injuries.
Nail bed avulsions are injuries where the nail and part of the nail bed are pulled away from the rest of the finger, often the ring finger. This commonly occurs when the finger gets stuck or jammed in something. Avulsion injuries are very painful and cause the finger to swell and potentially fracture. If the nail has not come off during the injury, it will need to be removed.
If you have a deep cut in your nail bed, you should see a doctor, especially if it doesn't stop bleeding. If the cut is serious, the nail might have to be removed, but it should grow back. Subungual hematomas that cover more than a quarter of the nail bed or are causing pain also need medical treatment. Antibiotics may be prescribed to prevent infection.
For minor injuries, you may be able to treat the injury at home. If the subungual hematoma is small (one-fourth the size of the nail or less) and there are no lacerations or avulsions of the nail, you don't need to see a doctor. You can wash any cuts or scrapes in soap and water, then apply a bandage. Keep the hand or foot elevated above the level of the heart to help with throbbing.
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Infection
If you experience a nail injury, there is a risk of infection, especially if the injury is deep or severe. It is important to be vigilant for any signs of infection, which can include:
- Warmth around the wound
- Redness
- Pain or throbbing
- Fever
- Swelling
- A red streak extending from the wound
- Pus-like drainage
If you notice any of these symptoms, it is important to seek medical attention promptly. In some cases, antibiotics may be prescribed to prevent or treat an infection.
To reduce the risk of infection, it is crucial to properly clean and care for the wound. Minor cuts and puncture wounds can often be treated at home. Wash your hands with soap or an antibacterial cleanser before treating the wound. Then, thoroughly clean the wound with mild soap and water, using direct pressure to stop any bleeding. Apply an antibacterial ointment and cover the wound with a clean bandage that will not stick to it.
For more serious nail injuries, it is recommended to seek medical attention at an urgent care center or emergency room. They will be able to properly clean and dress the wound, and may also provide a tetanus shot if necessary. In some cases, the nail may need to be removed to allow for proper healing.
It is important to keep the injured area elevated above the level of the heart to help reduce throbbing and swelling. Additionally, applying ice wrapped in a cloth for 20 minutes every 2 hours on the first day can help reduce pain and swelling.
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Frequently asked questions
A nail injury occurs when any part of the nail, nail bed, cuticle, or surrounding skin is injured. This can be caused by smashing your finger in a door, hitting it with a hammer, or cutting it with a knife.
If it is a minor cut, you can treat it at home by washing the wound with soap and water, applying antibacterial ointment, and bandaging it. Keep the injured area elevated above the level of your heart to reduce throbbing.
If the cut is deep, won't stop bleeding, or shows signs of infection such as redness, swelling, or pain, you should seek medical attention. Additionally, if there is any injury to the bone, you may need an X-ray and further treatment.
The treatment will depend on the extent of the injury. The doctor may create a small hole in the nail to drain blood and relieve pressure. If there is a fracture or tissue damage, the nail may need to be removed and the area treated with stitches or glue. Antibiotics may be prescribed to prevent infection.
A new fingernail typically takes about 4 to 6 months to grow back, while a toenail can take up to 12 months. The new nail may have ridges or be misshapen, which could be permanent.
