Caleb Foster
Fingernail and toenail injuries are common and can be caused by a blow to the nail, a heavy object falling on the nail, or by closing a finger in a door or drawer. This kind of trauma can result in blood under the nail (subungual hematoma), a condition that appears dark red and causes throbbing pain. If the injury is severe, with blood covering more than half of the nail, it is important to seek medical attention as it could indicate an underlying fracture or tissue tear. For milder injuries, first aid treatment includes trimming any hanging parts of the nail, gently cleaning the wound, and applying petroleum jelly to keep it moist.
| Characteristics | Values |
|---|---|
| Cause of injury | Blow to the nail, closing finger in a door or drawer, heavy object falling on nail, cutting with a sharp object |
| Symptoms | Blood under the nail, subungual hematoma (dark red appearance under the nail), throbbing pain, nail split, crack or lift |
| Immediate treatment | Wash with soap and water, remove rings, apply ice, wrap with gauze, elevate finger above heart level |
| Medical treatment | Drain blood from under the nail, stitches or glue for nail bed injury, antibiotics, splint or cast for bone fractures |
| Healing time | Nail bed heals in 7-10 days, new fingernail grows in 4-6 months, toenail in 12 months |
| Prevention | Keep nails short, wear properly-sized shoes, avoid nail biting and cuticle biting |
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What You'll Learn
If the injury is serious, seek medical attention
Fingernail injuries can be painful and may require medical attention, depending on the severity of the injury. If you experience a serious fingernail injury, it is important to seek medical attention to ensure proper healing and to prevent any potential complications. Here are some guidelines on when and why you should seek medical attention for a traumatic fingernail injury:
If you experience severe pain, bleeding, or if your nail is hanging off, it is advisable to seek medical attention. A doctor can examine the injury and determine the best course of treatment. In some cases, they may recommend X-rays to assess for any underlying bone fractures or tissue damage. If the injury involves the nail bed, prompt medical attention is often necessary to ensure the nail grows back smoothly. Receiving professional treatment can help ensure that the nail bed heals appropriately, and a smooth surface is formed for the new nail to grow.
In the case of a subungual hematoma, which is blood trapped under the nail, a doctor may perform a procedure called trephination. This involves making a small hole in the nail to drain the pooled blood and relieve pressure. If the injury includes the base of the nail or the nail matrix, a ridge or split can develop, and medical attention should be sought to ensure proper healing. Left untreated, some cosmetic changes may be permanent.
Additionally, if you are unable to bend your finger or toe, or if the injured area is black or purple, it is important to see a doctor as soon as possible. These could be signs of more serious underlying issues, and a dermatologist can help provide relief and evaluate for any potential complications. Remember to keep your tetanus vaccination up to date in the case of any nail injuries.
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Treat the wound with soap and water
If you have a traumatic hanging fingernail, it's important to treat the wound with soap and water to prevent infection and promote healing. Here's a step-by-step guide:
Step 1: Clean the Wound
Start by gently cleaning the affected area with soap and warm water. Use antibacterial soap if you have it, as this will help reduce the risk of infection. Wash for at least five minutes to ensure that any dirt, debris, and bacteria are removed. This is a crucial step to prevent infections such as paronychia, which can be caused by bacteria and germs that your hands come into contact with.
Step 2: Soak the Nail
Fill a bowl with warm water and soak the injured nail for 10 to 15 minutes. You can do this 2 to 4 times a day. The warm water will help soothe any discomfort and increase blood flow to the area, promoting healing. If you have bottled water, use that; otherwise, boil and cool your tap water to ensure it's free of contaminants.
Step 3: Dry and Moisturize
After soaking, gently dry your hands and apply petroleum jelly or a good-quality moisturizer to the entire hand, focusing on the affected area. This will help soften the skin around the hangnail, making it easier to manage.
Step 4: Trim the Hangnail
Using clean and sterile nail clippers, cuticle cutters, or small scissors, gently trim the hangnail as close to the nail bed as possible. Be careful not to press too deep, as the area underneath contains nerves and tiny blood vessels. If you trim too aggressively, you may cause bleeding and increase discomfort.
Step 5: Apply Antibiotic Cream
To further protect the area from infection and promote healing, apply a small amount of antibiotic cream, such as Neosporin, to the affected area. Your healthcare provider may recommend topical steroids or an antifungal cream if a fungal infection is suspected.
When to See a Doctor:
While you can often treat a traumatic hanging fingernail at home, there are times when you should seek medical attention. If you notice any signs of infection, such as redness, swelling, tenderness, or pus, and it doesn't improve with home care, consult a doctor. Additionally, if you have bleeding under the nail that covers more than half of the nail area, it's important to see a physician to evaluate for any underlying issues, such as a bone fracture or tissue tear.
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Apply a cool, damp washcloth to reduce swelling
If you have a traumatic fingernail hanging, you can apply a cool, damp washcloth to the wound to reduce swelling. This is a type of cold compress, which can be used to treat injuries and relieve pain. To make a cold compress with a washcloth, dampen the cloth, wring out any excess moisture, seal the cloth in a bag, and freeze it. Then, wrap the bag in a light cloth before applying it to your wound.
A cold compress can be helpful in reducing swelling, but it is important to note that it may not be sufficient for more serious injuries. In addition to cold therapy, you can also take ibuprofen or acetaminophen to help relieve pain and reduce swelling when your nail injury is new.
If your nail is hanging, it is important to first gently trim away any parts that are not connected to your skin. Then, clean the wound with soap and water. If there is bleeding, do not apply a dry bandage or gauze, as this will stick to the wound. Instead, apply petroleum jelly to keep the wound moist, and then cover it with gauze or a bandage. Change the dressing daily while the wound heals.
It is also important to keep your nail protected while it heals. Keep your nails short, and consider using buddy taping to stabilise the injured finger while it heals. Additionally, make sure your shoes fit properly to prevent toenail injuries.
If the injury is severe, such as if you cannot bend your finger or toe, there is blood covering more than half of your nail, or your nail is black or purple, seek emergency medical care.
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Manage pain and prevent infection
If you have a traumatic hanging fingernail, the first thing to do is to manage the pain and prevent infection. If the injury is particularly painful, seek emergency medical care. If the wound is bleeding, do not put a dry bandage or gauze on top as this will stick. Instead, apply petroleum jelly to keep the wound moist, then cover it with gauze or a bandage. Repeat these steps every day while the wound heals.
To reduce swelling, apply a cool, damp washcloth to the wound. Prop the injured arm or leg on pillows so that the nail is higher than your heart. Taking ibuprofen or acetaminophen can also help to relieve pain and reduce swelling when the nail injury is new.
To prevent infection, keep the wound clean. Soak the affected finger in clean, warm water for 10 to 15 minutes. Gently massage vitamin E oil, petroleum jelly, or mineral oil onto the area. Gently clip any loose parts of the nail with sterile nail clippers or scissors to prevent it from catching on anything and to reduce the risk of further injury or infection.
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Keep the wound moist and covered
If you have a traumatic fingernail hanging, it is important to keep the wound clean and protected. Here are some detailed steps to keep the wound moist and covered:
Firstly, if any part of the nail is hanging, gently trim away the detached portion with clean tools. This will prevent further injury and reduce the risk of infection. Next, gently clean the wound with soap and water to remove any dirt or debris. It is important to be gentle and thorough during this step to minimize the risk of infection.
Once the wound is clean, apply a thin layer of petroleum jelly to the affected area. This will keep the wound moist and promote healing. You can then cover the wound with a light dressing, such as a small piece of gauze or an adhesive bandage. This will provide padding and protection while the wound heals. It is important to keep the wound moist and covered, as this has been shown to promote faster healing and reduce scar formation compared to dry environments.
Repeat these steps daily, changing the dressing and reapplying petroleum jelly as needed. It is important to keep the wound clean, moist, and protected until it is fully healed. Additionally, make sure to keep your nails short while they heal to prevent further injuries and protect your hands by wearing gloves or using appropriate gear when necessary.
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Frequently asked questions
A traumatic fingernail hanging is when the nail is torn away from the skin, often due to a blow or crush injury.
If you have a traumatic fingernail hanging, you should first assess the severity of the injury. If the injury is mild, you can treat it at home by gently trimming away any part of the nail that is not connected to your skin, cleaning the wound, and applying a bandage. If the injury is severe, you should seek medical attention, especially if there is a large amount of bleeding or if the injury is very painful.
To treat a traumatic fingernail hanging at home, start by gently trimming away any part of the nail that is not connected to your skin. Then, clean the wound with soap and water and apply a bandage to keep it protected. You can also soak your finger in warm, soapy water and apply a moisturizer or petroleum jelly to keep the skin around your nail hydrated.
You should see a doctor for a traumatic fingernail hanging if the injury is severe, if there is a large amount of bleeding, if the injury is very painful, or if you suspect an infection. Additionally, if the injury involves the nail bed or the underlying bone, you should seek medical attention to ensure proper treatment and prevent future problems.
