Subungual hematoma: Difference between revisions
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#Trephination | #Trephination | ||
##Handheld cautery works best - no anesthesia is required | ##Handheld cautery works best - no anesthesia is required | ||
##Alternatively a needle | ##Alternatively a needle spun in a drilling fashion | ||
##Sharp object (i.e. safety pin) heated with flame in an austere environment | ##Sharp object (i.e. safety pin) heated with flame in an austere environment | ||
#If a fracture is present, the digit should be splinted | #If a fracture is present, the digit should be splinted | ||
Revision as of 01:33, 2 January 2015
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
- Alternatively a needle spun in a drilling fashion
- Sharp object (i.e. safety pin) heated with flame in an austere environment
- 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