Subungual hematoma

Background

• Consider intervention for hematoma >50% of nail bed

Subungal hematoma

All blood has been expelled through the trephination hole

Considerations

• melanoma
• kaposi sarcoma
• endocarditis

Types

• Simple - no nailbed dislocation, no e/o open fracture
• Complex - beyond simple

Management

Trephination

Simple

1. Trephination
   1. Handheld cautery works best - no anesthesia is required
2. If a fracture is present, the digit should be splinted
3. Instruct pts to soak affected finger in warm water BID-TID x7d

Complex

1. Nail removal only recommended if there is associated nail avulsion or nail fold disruption

See Also

• Radiograph-Negative Hand and Finger Injuries
• Nailbed laceration

Source

• Tintinalli