Caleb Foster
Fingernail injuries are common and can occur in many ways, such as catching your finger between two objects, hitting it with a heavy object, or cutting it with a sharp object. Depending on the severity of the injury, the nail may still grow back with small ridges or bumps. In this article, we will focus on why finger nails develop bumps after an injury.
| Characteristics | Values |
|---|---|
| Cause of injury | Blow to the nail, closing the finger in a door or drawer, cutting, tearing, smashing, bruising, or a splinter under the nail |
| Symptoms | Blood under the nail, nail split, cracked, or lifted away from the nail bed, throbbing pain, swelling, redness, warmth, tenderness |
| Treatment | Remove jewelry, gently wash the injury, apply a bandage, apply ice, take pain relievers, antibiotics, X-rays, trephination, repair nail bed, stitches, glue, splint |
| Healing time | 5-10 days for acute paronychia, several weeks for chronic paronychia, 4 weeks for broken bone, 6-9 months for full recovery, 2 months for fingernails to regrow, 4 months for toenails |
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What You'll Learn
- Nail injuries can cause blood to pool under the nail, known as subungual hematoma
- A severe injury may require removing the nail and repairing the nail bed
- A nail injury can lead to a bacterial infection called acute paronychia
- A bone fracture may require a splint for up to three weeks
- Treating a nail injury at home includes applying ice and keeping the hand elevated
Nail injuries can cause blood to pool under the nail, known as subungual hematoma
A bump on the fingernail after an injury is typically caused by blood pooling under the nail, known as a subungual hematoma. This condition is the result of small blood vessels under the nail bed leaking, causing blood to accumulate between the nail and the nail bed. The leakage occurs when the tips of the fingers experience a crushing injury or a heavy impact.
Subungual hematomas are characterised by a dark red discolouration under the nail, and the affected finger may be painful and throb. Treatment for this condition aims to relieve pressure by draining the trapped blood. In minor cases, subungual hematomas often heal on their own without the need for medical intervention, especially when no other injuries are present.
However, if the blood covers more than half of the nail bed, it is recommended to seek medical attention. A physician will evaluate the injury to rule out any underlying bone fractures or tissue tears. In more severe cases, a doctor may treat a subungual hematoma by creating a small hole in the nail, usually with a needle, to drain the pooled blood. This procedure is known as trephination and helps to alleviate pain and reduce pressure.
It is important to note that nails will not reattach to the nail bed after they have separated. If the nail has lifted completely off the nail bed, it may be more comfortable to temporarily replace and secure it with a bandage. In the case of a nail bed injury, the nail may need to be removed, and the nail bed repaired. With proper treatment, fingernails typically regrow completely within about two months, while toenails take approximately four months.
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A severe injury may require removing the nail and repairing the nail bed
Fingernail injuries can be caused by a blow to the nail, or by closing a finger in a door or drawer. This can result in blood under the nail, known as a subungual hematoma, which appears dark red and can be very painful. Nails can also be torn, split, or suffer a splinter. Repeated trauma to toenails can lead to deformities, and habits such as nail biting can cause acute paronychia, a bacterial infection.
In the case of a severe fingernail injury, it may be necessary to remove the nail and repair the nail bed. This is often required for nail bed avulsions, where the nail is torn away from the nail bed, and for fingertip fractures or amputations. If the bone is broken or the bruise is very large, the nail may need to be removed to relieve pressure and pain.
If the nail is removed, the wound will be cleaned and numbed with medicine. The doctor may create a small hole in the nail to drain blood and fluid, relieving pressure and pain. The nail may be reattached with special glue or stitches, or replaced with a special type of material. If the injury is serious, an X-ray may be required to check for broken bones.
After the nail is removed, it is important to keep the fingertip covered while the nail grows back. Fingernails typically take around three to six months to grow back fully, though some sources suggest it may take up to nine months for a normal nail to return. During this time, it is recommended to keep the hand elevated above the heart to reduce throbbing, and to take pain relievers as directed.
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A nail injury can lead to a bacterial infection called acute paronychia
A nail injury can occur when any part of the nail, including the nail, nail bed, cuticle, or surrounding skin, is damaged. This can happen when the nail is cut, torn, smashed, or bruised, or when the nail is torn away from the skin. Such injuries can lead to a bacterial infection called acute paronychia, which is an inflammation of the fingers or toes in one or more of the three nail folds.
Acute paronychia is caused by polymicrobial infections that occur when the protective nail barrier is breached, allowing bacteria to enter broken skin near the cuticle and nail fold. This can happen when the nail is bitten or picked at, or as a result of trauma to the nail bed or cuticle area from accidents, frequent manicures or pedicures, or certain medications. Nail biting is a common cause of acute paronychia, as it can introduce bacteria into the nail fold and cause swelling and irritation.
Symptoms of acute paronychia include pain, redness, swelling, and tenderness around the nail. The skin may be warm to the touch, and there may be pus-filled abscesses that require drainage. In some cases, the infection can spread and cause a serious hand infection called cellulitis, or it may involve underlying tendons in a condition called infectious tendonitis.
Treatment for acute paronychia typically involves warm soaks with or without Burow solution or 1% acetic acid. Topical antibiotics and/or steroids may be used if simple soaks do not relieve the inflammation. In some cases, oral antibiotics may be necessary for severe or prolonged infections. It is important to note that acute paronychia is usually a temporary condition that resolves within a few days and rarely recurs in healthy individuals.
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A bone fracture may require a splint for up to three weeks
Fingernail injuries can be caused by a blow to the nail, or by closing the finger in a door or drawer. This can result in blood under the nail, known as a subungual haematoma, which appears dark red and can be painful. Nails can also be torn, split, or suffer from a splinter. Repeated trauma to toenails can lead to deformities, such as thickening, discolouration, and lifting away from the nail bed.
Nail injuries can be treated at home if the bleeding can be stopped quickly, and the nail is not cut or torn and is still attached to the nail bed. For more serious injuries, urgent medical care should be sought. The treatment will depend on the type and seriousness of the injury. For larger bruises, a small hole may be created in the nail to allow blood and fluid to drain out and relieve pressure and pain. If the bone is broken, the nail may need to be removed, and the nail bed repaired.
A broken finger bone may require a splint for up to three weeks, depending on the severity of the injury. Splinting usually lasts for three to five weeks, with a cast typically being required for longer, around six to eight weeks. The injured part should be kept as still as possible in the first few days, and nurses will offer pain-relieving medication. The goal of fracture treatment is to restore the normal alignment of the bone so that it heals in the correct position. This may require sedation or anaesthesia.
In some cases, surgery may be required to repair a broken bone, and this can be treated with plates, screws, nails, or pins. Intramedullary nailing, for example, is an "indirect" treatment where a nail is placed in the marrow cavity of the bone, acting as an internal splint to allow for fracture alignment and healing. This is often used for long bone fractures in the femur and tibia. Hand and wrist fractures often heal within four to six weeks, whereas a tibia fracture may take 20 weeks or more.
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Treating a nail injury at home includes applying ice and keeping the hand elevated
A nail injury can occur when the nail, nail bed, cuticle, or skin around the nail is cut, torn, smashed, bruised, or torn away from the skin. This can be caused by a blow to the nail, closing the finger in a door or drawer, or cutting it with a sharp object.
Stop the Bleeding
If there is any bleeding, apply pressure with a clean cloth. This is crucial for home treatment, as any serious bleeding requires medical attention.
Assess the Injury
Once the bleeding has stopped, carefully remove the cloth and examine the injury. Home treatment is suitable only for specific types of nail injuries.
Minor Cuts and Scrapes
For minor cuts or scrapes, gently wash the area with soap and water, then apply a bandage.
Subungual Hematoma (Nail Bruise)
A subungual hematoma is a common nail injury that appears as a dark red discolouration under the nail, often causing pain and throbbing. If the bruise covers less than one-fourth (or 25%) of the nail, and there are no lacerations, avulsions, or deformities, it can be treated at home.
Apply Ice
To reduce pain and throbbing, apply ice wrapped in a cloth to the injured area for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that.
Elevate the Hand
Keep your hand elevated above the level of your heart to aid in pain control and reduce throbbing.
Take Pain Medication
Over-the-counter medications such as acetaminophen (avoid in case of swelling), ibuprofen, or naproxen can help with pain and swelling. Always consult with a healthcare provider before taking any medication, especially if you have a medical history of heart disease, high blood pressure, kidney disease, or stomach ulcers.
It is important to note that more serious nail injuries, such as lacerations, amputations, or fractures, require immediate medical attention. Do not attempt to treat these injuries at home.
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Frequently asked questions
A bump on your fingernail after an injury could be a sign of a ridge or split caused by trauma to the nail matrix, which is the tissue inside the cuticle where new nails form.
A subungual hematoma is a type of nail injury that occurs when blood pools between the nail and the nail bed, often as a result of crushing or heavy impact to the finger. It appears as a dark red discolouration under the nail and can cause pain and throbbing.
If the subungual hematoma is small (less than a quarter of the size of your nail), it can be treated at home by applying ice and keeping your hand elevated above your heart to reduce throbbing and swelling.
If the subungual hematoma covers more than half of your nail, you should see a doctor as it could indicate an underlying bone fracture or tissue tear. A doctor may drain the blood trapped under the nail through a small hole in the nail, usually made with a needle.
