Noah Sinclair
Smashed fingers are a common injury, often caused by a hammer blow, car door, or heavy object falling on the finger. The injury can lead to pain, stiffness, swelling, and bruising, with blood pooling beneath the fingernail, known as a subungual hematoma. Immediate treatment involves relieving pain and reducing swelling through ice packs, elevation, and over-the-counter pain medication. In some cases, a heated wire or paper clip may be used to burn a hole through the nail and drain the blood. While most smashed fingers heal within a few days, severe cases may take weeks, and medical attention should be sought for deep wounds, suspected fractures, or persistent symptoms.
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Bleeding under the nail
A smashed finger involves trauma to one or more fingers. It can lead to pain, stiffness, swelling, and bruising. In most cases, a smashed finger won't require medical treatment and can be treated at home with first aid, ice, and over-the-counter (OTC) pain relievers.
If there is blood beneath the fingernail, it is called a subungual hematoma. It usually happens if the nail gets crushed in an injury. It can cause symptoms such as intense pain and throbbing as blood collects under the nail. The blood pools and puts pressure on the nail plate, causing pain and discoloration.
If the pressure becomes too painful, it is advised to call your doctor. They may perform a simple draining procedure to relieve the pressure and give relief. They may numb the affected finger or toe with a nerve block and then use a heated wire, carbon laser, or needle to burn a hole or holes in the nail to allow the underlying blood to drain. After the procedure, your doctor will bandage your nail. You will need to keep the finger or toe bandaged and elevated and may also need to use cold compresses during the first 12 hours after decompression.
If the area of bleeding is very small, the nail will usually fall off on its own after several weeks because the pooled blood has separated it from its bed. A new fingernail can regrow in as little as 8 weeks, while a new toenail may take about 6 months to fully regrow.
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Pain and swelling
Smashed fingers can be extremely painful and are often accompanied by swelling. The pain and swelling can be treated at home with first aid, ice, and over-the-counter (OTC) pain relievers. However, if the pain and swelling persist or are severe, it is important to seek medical attention.
When a finger is smashed, blood can pool beneath the fingernail, leading to what is called a subungual hematoma. This can cause intense pain and throbbing as blood collects under the nail. The pressure generated by the pooled blood can be extremely painful and may require medical attention. In some cases, a doctor may perform a procedure called trephination or decompression to drain the blood and relieve the pressure and pain.
To treat pain and swelling at home, it is recommended to ice the injured finger for 15-minute intervals several times a day. It is important to wrap the ice in a cloth to prevent cold injury to the skin. Elevating the hand and using a cold compress can also help reduce pain and swelling. Over-the-counter pain medication can be used to manage discomfort when following dosage guidelines.
It is important to keep the injured area clean to prevent infection. Gently cleaning the area with mild soap and water can help remove any dirt or debris. Soaking the finger in warm, soapy water several times a day can also help keep the area clean and promote healing.
While most smashed fingers will start to feel better within a few days, more severe cases may take weeks to heal. It is important to rest the finger and avoid any activities that increase pain or involve a lot of finger strain. Stretching and gently massaging the finger can help improve recovery time by encouraging blood flow to the area.
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Bruising
A smashed finger can lead to bruising, pain, stiffness, and swelling. Bruising can occur under the fingernail, which is called a subungual hematoma. This happens when blood collects under the nail, causing it to turn purple, blue, or black. The pressure from the pooled blood can be extremely painful.
The bruise may remain visible for several months until the affected portion of the nail grows out. In some cases, the fingernail may fall off due to the pressure, but it will usually grow back within 8 weeks. To relieve the pain and pressure caused by a subungual hematoma, a doctor may perform a simple drainage procedure called decompression or trephination. This involves creating a small hole in the nail to allow the blood to drain.
It is important to seek medical attention if you experience severe pain, difficulty moving your finger, or if there are signs of infection such as redness, swelling, or fever. While most smashed fingers can be treated at home with ice and over-the-counter pain relievers, more severe cases may require medical intervention.
To prevent further injury, it is recommended to stop the activity that caused the smashed finger and gently clean the area with soap and water. Keeping the wound clean and applying a sterile bandage can help with the healing process. Elevating the injured finger and gently massaging the area can also aid in reducing swelling and improving blood flow.
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Loss of the nail
When a finger is smashed, blood can pool beneath the fingernail, leading to what is called a subungual hematoma. This can cause symptoms such as severe, throbbing pain and a dark-coloured discoloration (red, maroon, purple, blue, or even black) of the nail.
If the pressure beneath the nail becomes too painful, your healthcare provider may perform a procedure called trephination to drain the blood and relieve the pain. They may numb the finger with a nerve block and use a heated wire, carbon laser, or needle to make a small hole in the nail. Alternatively, you can use a heated paperclip to drain the blood yourself, but only if your healthcare provider recommends it. If you do drain the blood yourself, be careful not to press the paperclip too hard to avoid burning the skin underneath the nail. You will see drainage of clear or slightly bloody fluid for 2 to 3 days, which is normal. After the procedure, be sure to keep the finger bandaged and elevated and use cold compresses during the first 12 hours.
If the pressure becomes too severe, the fingernail may fall off on its own. In most cases, the nail will grow back in a few months, although toenails can take up to a year and a half to fully regrow. If the nail falls off, it is important to protect the sensitive skin of the nail bed with a Band-Aid to prevent dryness and cracking, which can affect how the nail grows.
If there is significant injury to the base of the nail or you are unable to control bleeding, it is important to seek medical attention.
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Medical treatment
Smashed fingers are a common injury, often caused by trauma to the finger, such as catching your finger in a door or hitting it with a hammer. The injury can lead to pain, stiffness, swelling, and bruising.
If you smash your finger, the first step is to relieve the swelling and pain with an ice pack, elevation, and an over-the-counter (OTC) pain medication if needed. It is important to wrap the ice pack in a clean cloth first to prevent cold injury to the skin. Apply ice for 15 minutes at a time, a couple of times an hour for the first few hours. Do not ice the finger for more than 15 minutes. Moving the finger can also help promote circulation and improve recovery time.
If there is blood beneath the fingernail, do not drain it yourself unless instructed to do so by a healthcare provider. If the pressure beneath the nail is causing severe pain, your healthcare provider may advise you to drain the blood yourself using a heated wire to burn a hole through the nail. This procedure requires a lighter, a pair of pliers, a clean paper clip, and a clean paper towel.
While most smashed fingers don't require medical treatment, you should seek treatment if there are signs of a fracture, the injury looks severe, or the pain and swelling persist. Additionally, seek medical attention if you are unable to move your finger, or if the skin is cut open and the bone is exposed. If the injury involves the palm or any of the joints, such as the finger or wrist, it is important to seek medical care.
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Frequently asked questions
To reduce swelling and redness, you should apply ice to the injured area. Wrap an ice pack or cold compress in a clean paper towel and place it on the injured finger.
If you are experiencing persistent bleeding or suspect that your finger is broken, you should seek medical attention. You should also seek medical attention if you are unable to move your finger or feel the tip of your finger.
Do not drain the blood yourself unless instructed to do so by a healthcare professional. If the pressure beneath the nail is causing severe pain, your healthcare provider may advise you to drain the blood yourself using a heated paperclip.
Most smashed fingernails start to feel better within 3 to 4 days. More severe injuries may take a few weeks or more to fully heal. It can take up to 9 months for the nail to grow back completely.
