View Full Version : Subungual Hematoma: Common and Painful

11-29-2009, 08:56 AM
This subject came up while I was speaking with someone via cellphone recently. I had suffered a firm whack on my thumb ealier, and the throbbing and swelling made it hard to push the cell buttons. Many of us have had this happen, and while I have suffered it many times, I learned how to mitigate the damage from a similar injury around 35 years ago. Just thought I'd pass this along since our crowded emergency rooms have curbed the desire to seek help there. letting a bad one go can extend the pain for several days. Here's a quick review:

Subungual Hematoma Overview
A subungual hematoma is a collection of blood in the space between the nailbed and fingernail. Subungual hematoma results from a direct injury to the fingernail. The pressure generated by this collection of blood under the nail causes intense pain.

The following are commonly used methods for draining your hematoma:
Cautery: A battery-operated device is used to burn a hole in the nail until the blood is reached and drains out the hole.
Needle: A large diameter needle is used to drill or bore into the nail to create a hole to allow the blood to drain out.

Paper clip: This technique, although an older one, is still used by some practitioners. A paper clip is opened so that the pointed end is free. Then the pointed end is heated up, usually by passing it through a flame, and used to burn through the nail. This technique uses a combination of the cautery method and the needle method.

My personal recommendation is for the hot poker device of whatever kind you can muster. Using the sharp knife is adding misery to suffering in my opinion, and compounded exponentially by the dullness of the cutting tool. But your poker must glow red hot, or you'll prolong the event and extend the fear. In many if not most cases, the peircing will bring immediate results as far as relieving the pain. The throbbing will usually subside in less than an hour, but it will remain sore to the touch and use for a day or more. Take it from an experience klutz; Learn this procedure and save yourself a lot of time holding your hand or toe above your heart.

Pictures of the injury:

This has been a public service message for the soon-to-be-dismissed middle class healthcare users.

11-29-2009, 10:36 AM
Thanks a million Doc but I think I will just be sure and be careful when driving a nail.:)

11-29-2009, 10:50 AM
Thanks a million Doc but I think I will just be sure and be careful when driving a nail.:)

Famous last words:p

11-29-2009, 11:53 AM
AG that hurt just reading it.

11-29-2009, 12:08 PM
This was over thirty years ago...

The boss was in a hurry, must have bid the job cheap - he was pushy as hell. I went to drive a six penny duplex nail without setting it and whacked my thumb full boogie on the thumb nail with a 32 ounce waffle headed framing hammer.

After dancing about and slinging my hand around for a while, I dug another nail out of my nail bag with my first two fingers, got the form up against my calf again, put the nail through the hole in the steel stake while holding the nail between forefinger and thumb... and whacked my thumb again.

I did the burn through the nail with a hot pin trick later on that evening.

A few years ago I was working with a tweeker who wasn't paying attention and stomped his right gaff right along side my left index finger as I was belting off. A quarter of inch or so different and I would have lost the first joint of my finger.

I went to a clinic where the doctor shot my finger up, removed the nail, and put a dressing on the bloody mess (didn't need stitches). Getting back to the job, I didn't want to get the dressing dirty, so I taped a piece of rag over it, resulting in a clown like cartoon finger.

At the end of the day, a young man asked me if he needed to move his vehicle (residential Santa Monica) for us. I replied no, and noticed that he was staring at my finger.

So, I began an elaborate, long winded tale of what we were going to do the rest of the week on that street while waving my hand with the bandaged finger around pointing in every direction possible. The man's head bobbed back and forth and up and down tracking that finger... it was hilarious.