Subungual hematoma: Difference between revisions
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[[File:Subungal hematoma.jpg|thumb|Subungal hematoma]] | [[File:Subungal hematoma.jpg|thumb|Subungal hematoma]] | ||
[[File:Post trephonation.jpg|thumb|All blood has been expelled through the trephination hole]] | [[File:Post trephonation.jpg|thumb|All blood has been expelled through the trephination hole]] | ||
==Types== | ===Types=== | ||
*Simple - no nailbed dislocation, no e/o open fracture | *Simple - no nailbed dislocation, no e/o open fracture | ||
*Complex - beyond simple | *Complex - beyond simple | ||
==Differential Diagnosis== | |||
{{DDX distal finger}} | |||
==Management== | ==Management== | ||
Revision as of 11:58, 30 September 2014
Background
- Consider intervention for hematoma >50% of nail bed
Types
- Simple - no nailbed dislocation, no e/o open fracture
- Complex - beyond simple
Differential Diagnosis
Distal Finger (Including Nail) Injury
- Distal interphalangeal dislocation (finger)
- Distal phalanx (finger) fracture
- Finger amputation
- Fingertip avulsion
- Finger infection
- Nailbed laceration
- Nail avulsion
- Subungual hematoma
Management
Simple
- Trephination
- Handheld cautery works best - no anesthesia is required
- If a fracture is present, the digit should be splinted
- Instruct pts to soak affected finger in warm water BID-TID x7d
Complex
- Nail removal only recommended if there is associated nail avulsion or nail fold disruption
See Also
Source
- Tintinalli