Doctor's Notes on Subungual Hematoma (Bleeding Under Nail)
A subungual hematoma refers to a collection of blood beneath the fingernail or toenail. The cause of a subungual hematoma is usually direct trauma or injury to the nail, such as hitting the finger or toe with a heavy object, or closing the finger in a door. This is a common type of injury to the fingernail. If there has been an injury to the hand or finger, a subungual hematoma may be associated with other injuries to the area such as a fracture of bones.
The collection of blood between the nail bed and the nail causes pressure and typically leads to intense pain. There is a discoloration of the nail, with the area of bleeding taking on a red, blue-black, maroon, or other dark color. Other associated signs and symptoms may be present if there is another underlying injury.
What Is the Treatment for Subungual Hematoma?
If the hematoma is small and not causing pain, treatment may not be required.
For a large or painful hematoma, decompression or draining of the hematoma can be performed. This is done by numbing the affected finger or toe and using one of a variety of methods, including heat or a needle, to open the nail and create a hole for the blood to drain.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.