Footnotes / Blog
What is a Subungual Hematoma?
A subungual hematoma is a condition that occurs when the toenail is crushed or injured, causing blood to collect underneath the nail. This can lead to intense pain and throbbing as the blood builds up. It is commonly caused by an object being dropped on the foot or when the toe gets forcefully stuck between two objects.
Causes and Diagnosis of Subungual Hematoma
A subungual hematoma occurs when trauma to the toenail causes blood vessels under the nail to rupture. If you experience this condition, you’re likely dealing with significant pain and swelling in the affected toe. Upon visiting a doctor, the area will be carefully examined. Your doctor may also order an X-ray to rule out bone fractures in the toe.
Additionally, the doctor will evaluate how much of the nail has blood underneath it, which will help determine the best course of treatment.
Treatment for Subungual Hematoma
To alleviate pain and reduce pressure, a procedure known as decompression (or trephination) is often performed. This allows the blood under the nail to drain, providing relief from the intense throbbing.
The decompression procedure may involve:
- Cautery: The doctor uses a heated wire to create a small hole in the nail. The heat is controlled to prevent damage to the nail bed, making this a quick and generally painless method.
- Needle: Alternatively, the doctor may use a needle to make a hole in the nail, allowing the blood to drain.
After the procedure, the affected toe or finger will be bandaged. It’s important to keep the area elevated, and you may be advised to apply cold compresses for the first 12 hours to reduce swelling. Your doctor might also recommend using a splint for up to three days to help ease any remaining tenderness.
Possible Complications
While decompression is generally safe, there is a small risk of infection in the remaining hematoma or nail bed. If a significant portion of the nail has been affected and the nail bed is damaged, your doctor may need to remove the entire nail and use stitches to repair the bed.
When to Seek Treatment
If you have a painful subungual hematoma or suspect a toenail injury, it’s important to seek professional care. Early treatment can help alleviate pain and reduce the risk of complications.
At Innovative Foot and Ankle, we have a team of experienced doctors who can evaluate and treat your foot and ankle injuries. Our offices are located throughout Northern New Jersey, and we are here to help with any toenail injuries you may have.
