hematoma, subungual

A subungual hematoma is a blood clot that forms under an injured finger- or toenail. The usual injury is a pinch, or for the toenail, dropping a heavy object onto the toe. Bleeding under the nail presses on the sensitive nailbed, and throbbing pain is the result.

This is easy to fix. We take a heated wire apparatus or a tiny drill and drill through the nail (in a pinch a red-hot paperclip will do). This is totally painless if done correctly (but potentially a little scary for the child). Old liquified blood gushes out, the pressure is relieved, and everyone goes home happy. The nail maybe shed subsequently, or if the trauma was not too severe, there will simply be a persistent dark discoloration of the nail that will eventually grow out and disappear. Not to worry.

This same procedure - creating a hole in the nail to relieve pressure - is sometimes necessary to relieve pressure from pus under the nail as well.

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