A blood under nail (known as subungual hematoma) is a condition where there is bleeding under the fingernail or toenail. Generally triggered by a crush injury, a subungual hematoma can cause symptoms such as extreme pain and throbbing as blood collects under the nail.
Unless there are likewise broken bones or damage to the nail bed and/or surrounding tissues, a subungual hematoma is rarely uneasy.
Causes of Blood under Nail after Big Toe Injury
Usually, a subungual hematoma is an immediate repercussion of a crush-type injury including the pointer of the finger or toe. Typical examples consist of:
- Slamming your finger in a car door or house door.
- Hitting your finger with a heavy item such as a hammer.
- Dropping a heavy things such as a dumbbell on your toe.
- Stubbing your toe on a hard surface area.
Sometimes, a tumor under the nail can trigger a darkened area that can resemble a subungual hematoma. If you have a dark area under a big toe nail, and no history of injury to the nail, you should have it assessed by your healthcare carrier. The spot will grow out with the nail if it is a subungual hematoma. It will stay in the very same spot under the nail if it is a growth.
Symptoms of a Subungual Hematoma
The most common symptom of a blood under nail after big toe injury is severe, throbbing pain produced by the pressure of blood collecting between the nail and the nail bed. Other symptoms consist of:
A dark-colored staining (red, maroon, or purple-black) under all or part of the influenced nail.
Tenderness and swelling of the suggestion of the influenced finger or toe.
Diagnosis of a Subungual Hematoma
If a subungual hematoma was triggered by a severe blow to a finger or toe, either look for instant medical attention from your health care service provider or go to an emergency clinic. In addition to the hematoma, you may have broken bones or severe damage to the nail bed and/or surrounding tissues.
The healthcare service provider will analyze your nail and you’ll likely go through an X-ray to either confirm or rule out a bone fracture or other injury.
How to Treat a Blood under Nail after Big Toe Injury
A painless and small subungual hematoma typically requires no treatment. However, the pressure created by pooled blood under the nail can be very unpleasant. To eliminate the pain, your health care carrier may carry out decompression, also called trephination, which permits the underlying blood to drain, relieving pressure and pain to the area.
After numbing the influenced finger or toe with a nerve block, your healthcare carrier may use among the following decompression techniques to drain the subungual hematoma:
- Cautery. A heated wire (electrocautery gadget) or carbon laser is used to burn the hole or holes. This is a fast and pain-free procedure.
- Needle. A large-diameter needle is used to perforate the nail.
Throughout the cautery treatment, the heated idea is cooled by contact with the hematoma, which prevents injury to the nail bed.
After a decompression treatment, your nail will be bandaged. You will have to keep the finger or toe bandaged and elevated– and utilize cold compresses, if required– during the first 12 hours following decompression. In some cases, your healthcare service provider may recommend you use a splint for as long as three days until the tenderness subsides.
The primary problem associated with decompression is a little risk of infection in the recurring hematoma.
Treatment of a Complicated Blood under Big Toe Nail
If a subungual hematoma after big toe injury affects a huge part of the nail surface area, the nail bed is likely to have substantial injury. In these cases, nail removal might be needed, together with stitches to the nail bed.
Resolution of a Subungual Hematoma
Unless a subungual hematoma is extremely small, an affected nail will usually fall off by itself after numerous weeks because the pooled blood has separated it from its bed. A new fingernail can grow back in as low as eight weeks while a brand-new toenail might not completely grow back until about 6 months. If there has been injury to the nail bed and/or surrounding tissues, regrowth might be delayed.
Even with the best repair work, there is still a possibility that the new nail might grow back with an abnormal appearance. See your healthcare service provider if you see any problems with the nail as it recovers and regrows.
I slammed my middle finger on a door 3 days ago and over the past few days the subungual hematoma has gradually increased in area under my fingernail and is now occupying around 60-65% of my nail bed area so it’s quite large. There is no acute pain but there’s a very faint throbbing and it hurts a lot if I accidentally hit the aforementioned finger somewhere. Do I need to consult a doctor to drain the blood or can this (the pooled blood under my fingernail – subungual hematoma) go away by itself? If so, around how long will it take?
I strictly recommend you to visit a doctor to avoid undesirable effects of the trauma. Probably doctor will ask for x-ray to ensure finger bone is not cracked, may prescript you some anti-inflammatory medications or something else.
We try give valuable information for site visitor but at the end everybody should visit specialists for “face-to-face” examination. But information from our articles should help to readers ask proper questions to MD regarding issues happen.
I wish you sort you problem out quick and painless.
To be blunt, that nail is going to fall off. I use the smallest size drill bit you can find, and dill a tiny hole into the nail. You may have some blood squirt out, that is normal, but it will also get rid of the pain. Your nail should grow back, just fine. I have hit my bed post several times at night time, and does it ever hurt when you do it. But all will be well, once you drill that small hole.
Reyus – Stubbed my toe four months ago. Was tender but didnt notice purple nail for about a week due to nail polish. Large area was bruised and tender, then toe felt normal for quite a while. Recently the toe has become extremely tender with a slight ache. Nail still on but largely still purple except for about 1/8″ of new growth. Should I consult a doctor?
Andrea, I will recommend you visit a surgeon ASAP apart of other doctor. According you description I prefer you check for gangrene of the toe. I wish you it is only precoution, no more but I had similar situation with my relative – it was gangrene (atherosclerosis of the lower extremities).
So – of cause, visit a doctor ASAP.