Nail injuries can include a bruise beneath the nail or splitting of the nail from the nail bed. Remember that they can be complicated wounds to fix. Lasting deformity to the nail can occur even after proper repair has been carried out.
It is important to note that the fingernail provides support to the finger pad and improves sensation.
There are different forms of nail injuries that can occur. In some cases, a combination of these injuries involves the same nail.
- Laceration involves a cut through the nail, nail bed, lateral nail folds, cuticle or any of these. Blood is always visible on the skin and the affected nail appears mangled depending on the type of injury.
- Subungual hematoma or bruise is the buildup of blood beneath the nail, usually reddish or purplish in color that fades to blue after a few weeks. The whole finger throbs and painful to the touch. This injury can arise on its own or seen with other forms of nail injuries.
- Amputation of the fingertip occurs when a region of the fingertip includes a part, or the entire nail is detached from the rest of the finger.
- Avulsion of the nail arises when a region of the nail is raised off the nail bed or sticking out of the skin at the nail base. Blood is usually visible and often linked with a laceration.
- A bone fracture beneath the nail might also be linked with nail injuries especially with the crushing type.
Management of nail injuries
When dealing with nail injuries, it is vital to provide appropriate wound management as well as assessment of the injury.
- The initial step is the removal of all jewelry before swelling arises.
- Control bleeding by placing pressure using a clean towel or cloth. Once the bleeding has ceased, get rid of the cloth and assess the injury.
- Treatment at home is enough if the damage the injury is a subungual hematoma that the individual does not want to be drained or only covers less than 25% of the nail, finger or toe is not deformed or bent and if there are no avulsions or lacerations.
- Make sure that the affected foot or hand is raised higher than the level of the heart to alleviate the throbbing.
- Pain medications can be given to lessen the discomfort.
- Any scrapes or cuts must be washed with water and soap and apply a bandage.
If there is a laceration, avulsion, finger or toe is bent or a large-sized bruise on the nail, it requires further care in a healthcare facility.
Do not attempt to pull the nail or remove if from the nail bed. Any amputated parts must be wrapped in a damp paper towel and stored in a plastic bag and placed on ice. This must be taken along with the individual to the emergency department.
Disclaimer / More Information
The information posted on this page on nail injuries is for learning and educational purposes only. To learn to properly care for nail injuries, register for first aid training at one of our training centers located throughout Canada. The training centers are in Edmonton, Calgary, Vancouver, Kelowna, Saskatoon, Victoria, Surrey, Mississauga, Winnipeg, Red Deer, Toronto, Ottawa and Halifax.