Subungual hematoma
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords:
Overview
A subungual hematoma[1] is a collection of blood (hematoma) underneath a toenail or fingernail which often results from a traumatic injury such as slamming a finger in a door. A laceration of the nail bed causes bleeding into the constricted area underneath the hard nail plate. Because the blood disrupts the connections between the nail bed and nail plate, throbbing pain is common. The nail develops a black discoloration overlying the laceration.
Historical Perspective
Classification
Pathophysiology
Genetics
Associated Conditions
Causes
Differentiating type page name here from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Symptoms
Family History
Physical Examination
Appearance of the Patient
Vital Signs
Skin
Head
Eyes
Ear
Nose
Throat
Heart
Lungs
Abdomen
Extremities
Neurologic
Other
Laboratory Findings
Biomarker Studies
CT
MRI
Ultrasound
Treatment
Pharmacotherapy
Acute Pharmacotherapies
Chronic Pharmacotherapies
Surgery and Device Based Therapy
Subungual hematomas are treated by either releasing the pressure by drilling a hole through the nail into the hematoma (trephining) or by removing the entire nail. Trephining is generally accomplished by using a heated instrument to pass through the nail into the blood clot. It should be noted that a heated instrument is not used on acrylic nails because they are flammable. Removal of the nail is typically done when the nail itself is disrupted, a large laceration requiring suturing is suspected, or there is a fracture of the tip of the finger. Although anesthesia is generally not required, a digital nerve block may be performed if the nail is to be removed. Subungual hematomas typically heal without incident, though infection or disruption of the nail (onycholysis) may occur.
Indications for Surgery
Pre-Operative Assessment
Post-Operative Management
Primary Prevention
Genetic Counseling
References
- ↑ Henretig, Fred M.; Fleisher, Gary R.; Ludwig, Stephen (2006). Textbook of pediatric emergency medicine. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-5074-1.