Signs of Nail bruise (Subungual hematoma)

Nail Bruise (Subungual Hematoma)

Description

A bruise (hematoma) that develops under the fingernail after trauma to the finger. Bruises develop when small blood vessels under the nail tear or rupture. Blood leaks into tissues under the nail and causes the black-and-blue color. The blood becomes trapped under the nail and with time causes increasing pain and pressure.

Symptoms

Bluish-purple discoloration under the nail, pain that increases with passage of time, throbbing pain, finger swelling.

Tests

A history and physical exam will be performed. An X-ray may be done to identify an associated fracture.

Standard Workup

X-Ray

Treatment

Drainage (trephanation) of the hematoma by drilling or burring a hole in the nail is the standard treatment. Pain medications such as acetaminophen (Tylenol), and/or nonsteroidal anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn) are prescribed. A finger guard may be applied to prevent further injury during the healing process.