User:Mr. Ibrahem/Subungual hematoma

A subungual hematoma is a collection of blood underneath a fingernail or toenail. It can be painful. The discoloration of the nail may range from reddish to purple to black. The injury may be complicated by a fracture of the finger tip or a mallet finger.

The cause is generally a direct blow or crush injury to the finger tip. Other causes may include repetitive injury such as from poorly fitting shoes, certain tumors and splinter hemorrhages. Risk factors include anticoagulants (blood thinners).

Treatment of painful cases as a result of injury is by drilling a small hole in the nail. This can be done by rotating an 18 gauge needle. A digital block may be done for pain, but is generally not required. Antibiotics are generally not needed. People may still eventually lose the nail. These injuries are common.