Subungual hematoma
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| Subungual hematoma Classification and external resources |
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| Subungual hematoma | |
| ICD-10 | L60.8 (ILDS L60.872) |
| ICD-9 | 924.3 |
A subungual hematoma is a collection of blood (hematoma) underneath a toenail or fingernail.
[edit] Causes
It often results from a traumatic injury such as slamming a finger in a door. A laceration of the nail bed causes bleeding into the constricted area underneath the hard nail plate.[1] Because the blood disrupts the connections between the nail bed and nail plate, throbbing pain is common. The nail develops a black discoloration overlying the laceration.
[edit] Treatment
Subungual hematomas are treated by either releasing the pressure by drilling a hole through the nail into the hematoma (trephining) or by removing the entire nail. Trephining is generally accomplished by using a heated instrument to pass through the nail into the blood clot. Removal of the nail is typically done when the nail itself is disrupted, a large laceration requiring suturing is suspected, or there is a fracture of the tip of the finger. Although anesthesia is generally not required, a digital nerve block may be performed if the nail is to be removed. Subungual hematomas typically heal without incident, though infection or disruption of the nail (onycholysis) may occur.
[edit] References
- ^ Selbst, SM, Attia, M (2006). Textbook Of Pediatric Emergency Medicine. Hagerstwon, MD: Lippincott Williams & Wilkins, 1571 "Lacerations". ISBN 0781750741.
