Liam Carter
Slamming your finger in a door can be extremely painful and cause a variety of injuries. One of the most common injuries is a subungual hematoma, which is a pool of blood that collects under the nail after an injury. This can cause extreme pressure on your finger nerves, leading to excruciating pain. In some cases, the nail may fall off immediately or weeks after the injury. The nail bed will take about 7 to 10 days to heal, and a new fingernail will take about 4 to 6 months to grow back.
| Characteristics | Values |
|---|---|
| Will the nail fall off? | Yes, the nail may fall off within a week or two of the injury. |
| What to do in case of a smashed finger? | Clean the area with soap and water or an antibacterial rinse. Cover the wound with sterile gauze or bandages. |
| How to reduce inflammation and pain? | Apply ice wrapped in a hand towel or cloth for 20 minutes every 2 hours on the first day, then 3-4 times a day after that. Keep the injured finger raised above the level of your heart to slow the blood flow to the site. Take OTC anti-inflammatory medications like ibuprofen, acetaminophen, or aspirin. |
| When to see a doctor? | If you experience persistent bleeding, broken finger, loss of blood flow, loss of sensation, unusual colors in your fingertip, large subungual hematoma, signs of infection, or persistent pain. |
| How long does it take for the nail to grow back? | A new fingernail will take about 4 to 6 months to grow back. Toenails can take up to 12-18 months. |
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Subungual haematoma
The first step in managing a subungual haematoma is to address any immediate first aid needs. This includes basic wound care: applying pressure to control bleeding, cleaning the wound with soap and water, and covering it with a bandage. Icing the injury can help reduce swelling and pain. It is important to elevate the injured hand or foot above the level of the heart to slow down blood flow to the site, which aids in reducing inflammation and pain. Over-the-counter anti-inflammatory medications, such as ibuprofen or aspirin, can also be taken to manage pain and reduce inflammation.
If the subungual haematoma is large, with blood encompassing more than 50% of the nail, it is recommended to seek medical attention within 24 hours. Doctors can drain the accumulated blood by performing decompression or trephination, which involves making a small hole in the nail to relieve pressure and pain. This procedure is typically done within 48 hours of the injury and is often performed by emergency department physicians or nurse practitioners.
In most cases, the fingernail will remain in place, but it may fall off within a week or two of the injury. During this time, it is important to protect the sensitive skin of the nail bed with a bandage to prevent dryness and cracking, which can affect nail growth. A new nail will typically take 4 to 6 months to grow back, and it may have grooves or ridges, indicating permanent misshapen growth.
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Nail bed injury
Slamming your finger in a door can cause a nail bed injury. These injuries are common, with fingertip injuries being the most commonly seen hand injuries. The fingertip is frequently injured because it is the point of interaction between the body and its surroundings in most daily activities.
Nail bed injuries are often increasingly painful. As blood accumulates in the small space beneath the nail, it puts pressure on the tender skin of the nail bed. Sometimes, the nail lifts away from the nail bed. Another type of nail bed injury is a cut or laceration that pierces the nail and nail bed beneath. Crush injuries squeeze the soft tissue of the nail bed between the nail and the distal phalanx. This may result in a simple subungual hematoma or a simple or stellate laceration.
If you have a nail bed injury, you should gently clean the area with soap and water or an antibacterial rinse and cover the wound with sterile gauze or bandages. You can also apply ice wrapped in a hand towel or cloth to the injured finger for up to 20-minute intervals, several times a day. Raising the injured finger above the level of your heart slows the flood of blood to the site and can help reduce inflammation and ease throbbing pain. Over-the-counter anti-inflammatory and pain medications like ibuprofen, acetaminophen, and aspirin can help reduce inflammation and associated pain.
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, and it may be misshapen. Toenails take about 12 months to grow back. If you have a broken bone, your provider may need to place a wire in your finger to keep the bone in place.
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Nail regrowth
If you've lost a nail due to an injury, it's important to keep the nail bed clean, dry, and protected while you wait for a new nail to grow. It usually takes about 7 to 10 days for the nail bed to heal, and a new fingernail will take about 4 to 6 months to grow back. Toenails typically take longer to regrow, ranging from 12 to 18 months.
During the healing process, it's crucial to prevent infection and promote nail regrowth. Here are some steps to facilitate nail regrowth after an injury:
- Treat inflammation: Inflammation is the primary cause of pain, swelling, and redness or discoloration. OTC anti-inflammatory medications, such as ibuprofen or naproxen, can help reduce inflammation and associated pain.
- Manage bleeding: To stop the bleeding, gently clean the area with soap and water or an antibacterial rinse, and cover the wound with sterile gauze or bandages. Applying ice wrapped in a cloth for 20-minute intervals several times a day can help stop bleeding and prevent a blood blister from forming under the nail.
- Prevent infection: Keep the injured area clean and dry. OTC antibiotic ointments or creams can be applied to the wounds after cleaning to prevent infection.
- Protect the nail bed: If you have an artificial nail, it can be kept in place until the nail bed heals. Trimming any sharp edges or detached parts of the nail can also help prevent further injury. Covering the nail with tape or an adhesive bandage can provide additional protection until the nail has grown out enough.
- Monitor for signs of infection: In the days following the injury, watch for signs of infection, such as pus, intense redness, heat, or significant swelling. If these symptoms occur, consult a doctor for further treatment.
- Facilitate nail regrowth: Nails grow from the matrix, or the root of the nail, where new cells form. Factors such as increased blood flow to the injured area, overall health, and seasonal variations can influence the rate of nail regrowth.
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Pain management
Slamming your finger in a door can be a painful and distressing experience. While minor injuries may heal on their own, it is important to assess the damage and treat the injury to reduce pain and aid in the healing process.
First, check for signs of injury, such as pain, swelling, stiffness, and bleeding. If there is bleeding, apply pressure to the area to slow it down. If there is severe bleeding or a lot of blood under your fingernail, seek medical attention. If there are minor cuts or scrapes, gently clean the area with soap and water or an antibacterial rinse, then cover the wound with sterile gauze or bandages. Change the dressing at least twice daily.
To reduce pain and swelling, apply ice wrapped in a hand towel or cloth to the injured finger for up to 20-minute intervals, several times a day. You can also submerge your finger in a bowl of cold water for up to 20 minutes at a time. Keep your hand elevated above the level of your heart to slow the flood of blood to the site, which will help reduce inflammation and ease throbbing pain.
Over-the-counter pain medication can also help to reduce pain and inflammation. Options include ibuprofen (Advil, Motrin), acetaminophen (Tylenol), and aspirin. Topical analgesics, such as creams or gels containing numbing agents like lidocaine, can also be applied to the affected area for temporary pain relief.
If there is severe pain, there is a deformity, a laceration, discoloration, numbness, or an inability to move your finger, seek medical attention. A bent finger that you can't fully extend is a sign of a fracture, which may require a splint and prescription pain medication.
If your fingernail falls off due to the injury, protect the sensitive skin of the nail bed with a Band-Aid to prevent dryness and cracking, which can affect how the nail grows back. A new fingernail will typically take about 4 to 6 months to grow back.
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Medical attention
If you've slammed your finger in a door, it's important to assess the damage and determine whether you need medical attention. While minor injuries may heal on their own with at-home care, more severe injuries may require medical intervention. Here are some guidelines on when to seek medical attention for a smashed finger:
When to Seek Medical Attention:
- Persistent bleeding: If you are unable to stop the bleeding, or if the bleeding is severe, seek medical attention.
- Broken finger: If you suspect that your finger might be broken, especially if there is a visible deformity or you are unable to move your finger, it's important to get medical care.
- Deep wounds: Deep wounds that may require stitches or involve exposed bone should be treated by a medical professional.
- Fractured finger: If there are obvious signs of a fracture, such as hearing a crack when the injury occurred or the presence of bone fragments piercing the skin, seek immediate medical attention.
- Amputation: If the injury involves a partial or full amputation of the fingertip, immediate medical care is necessary due to the potential for nerve damage and complications with hand function.
- Loss of sensation: If you have lost feeling in the fingertip or are unable to move it, this could indicate nerve damage and requires medical attention.
- Infection: If you notice signs of infection, such as pus, increased redness and warmth, swelling, or persistent pain, see a doctor as soon as possible.
- Nail injury: If the nail is cut, torn, or detached from the nail bed, you may need medical attention. In some cases, a special material can be applied to the nail bed to protect it while it heals.
- Joint involvement: If the injury involves the joints in your finger or wrist, it's important to seek medical care to rule out any potential complications.
First Aid and At-Home Care:
While minor injuries can often be managed at home, it's important to follow proper first aid and care procedures. Here are some general guidelines:
- Rest and ice: Apply ice wrapped in a cloth to the injured finger for 15 to 20 minutes at a time, several times a day. This will help reduce pain, swelling, and bleeding.
- Elevation: Keep your hand raised above the level of your heart to slow down the blood flow to the injury and reduce throbbing and bleeding.
- Clean the wound: Gently clean any minor cuts or scrapes with soap and water or a sterile saline solution.
- Bandage: Cover the wound with sterile gauze or bandages to protect the injury and minimize bleeding.
- Pain relief: Over-the-counter pain relievers, such as ibuprofen, acetaminophen, or aspirin, can help reduce inflammation and associated pain.
- Antibiotics: If there is an open wound, your doctor may prescribe antibiotics to prevent infection.
- Nail bruising: If the nail is bruised but still attached, it will usually heal on its own. However, monitor the area for signs of infection and apply antibiotic ointments or creams to prevent infection.
Remember, if you are unsure about the severity of your injury, it's always best to err on the side of caution and seek medical attention. A medical professional can provide a proper assessment and determine the best course of treatment.
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Frequently asked questions
If there is bleeding, gently clean the area with soap and water or an antibacterial rinse, and cover the wound with sterile gauze or bandages. You can also apply ice wrapped in a hand towel or cloth to the injured finger for up to 20-minute intervals, several times a day.
A subungual hematoma is a pool of blood that collects under a nail after an injury. It is often very painful and can cause pressure on your finger nerves.
If you see blood or a bruise under your nail after an injury, seek medical care within 48 hours. A healthcare provider can perform a procedure called trephination to drain the blood and relieve the pressure and pain.
In some cases, your nail may fall off—either right away or within a few weeks. If the nail remains in place, you may notice discoloration around the site of the injury.
It can take anywhere from 4 to 6 months for a fingernail to grow back, and up to 12-18 months for a toenail. The new nail may have grooves, ridges, or be misshapen.
