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Subungual Hematoma (Bleeding Under Nail)

Subungual Hematoma Facts

  • A subungual hematoma is a collection of blood in the space between the nail bed and fingernail.
  • Subungual hematomas result from a direct injury to the fingernail.
  • The pressure generated by this collection of blood under the nail causes intense pain.

Subungual Hematoma Causes

  • Subungual hematomas most commonly form after a crush-type injury to the tip of the finger or toe.
  • This injury can occur in many ways:
    • Hitting your finger with a hammer
    • Dropping a heavy object on your toe
    • Closing your finger in a door

Subungual Hematoma Symptoms and Signs

  • Blood underneath the nail of either a finger or toe is a subungual hematoma.
    • You will have a discoloration of red, maroon, or other dark color beneath the nail after an injury.
  • The most common symptom is intense pain.
    • Pressure generated between the nail and the nail bed, where the blood collects, causes this pain.
    • The pain may also be caused by other injuries such as a fracture (break) to the underlying bone, a cut in the nail bed, or bruising to the finger or toe itself.
Medically Reviewed by a Doctor on 5/18/2016
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Subungual Hematoma (Bleeding Under Nail) - Causes

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Subungual Hematoma - Treatment

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Treatment of an Uncomplicated Subungual Hematoma

A painless and small subungual hematoma usually requires no treatment. However, the pressure generated by pooled blood under the nail can be extremely painful. To relieve the pain, doctors perform decompression, also called trephination, which allows the underlying blood to drain, relieving pressure and pain to the area.

After numbing the affected finger or toe with a nerve block, doctors commonly use several decompression methods to drain a subungual hematoma:

  • Cautery. A heated wire (electrocautery device) is used to burn the hole or holes during a painless procedure that takes only a few seconds.
  • Paper-clip method. A heated paper clip is placed over the center of the hematoma to melt a hole into the nail.
  • Needle. A large-diameter needle is used to perforate the nail.

SOURCE: WebMD Medical Reference

Read What Your Physician is Reading on Medscape

Hand, Subungual Hematoma Drainage »

Subungual hematomas are common nail bed injuries caused by blunt or sharp trauma to the fingers or toes.

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