What To Do When You Encounter Subungual Hematomas

About Subungual Hematomas

Suppose you are moving to a new home, are moving heavy boxes around, and accidentally drop one of those heavy boxes on your toes. After walking off the pain, you notice big toe nail is getting darker color than the surrounding nail, and it still hurts.  This is a classic case of developing a subungual hematoma. Subungual Hematoma refers to bleeding beneath the nail plates and is most often associated with trauma, such as a crush injury. Subungual Hematomas occur due to blood accumulating under the nail.  When the nail suffers trauma, it allows the space under the nail to fill with blood, which causes increased pressure beneath the nail.

How do I know if I have a Subungual Hematoma?

If a patient has recently suffered a crush injury/trauma, notices a swollen toe, and says the pain is throbbing, it is likely nail bed damage, and a subungual hematoma is present. Since blood tends to accumulate in the potential space between the nail plate, the blood can be visually noticeable, and will appear as a dark red, or brown color on the nail. Since subungual hematomas tend to occur most with crush injuries, it is also likely more damage to the toes can be sustained. A few examples include: fracture to the toes, damage to the nail plate, and pushing the nail plate into the nail fold. Since these could occur, it is a good idea to have an x-ray taken to see if any underlying bone damage has occurred.

Treating your Subungual Hematoma

Treatment of a subungual hematoma can vary depending on how severe the bleeding is beneath the nail. If it is minor, such as a tiny line of blood, then it is likely the subungual pressure is not severe and will not need to be drained. However, if there is a lot of blood beneath the nail, and the pain is excruciating, then treatment will involve reducing the pressure underneath the nail. This can be accomplished using several different methods, all of which involve penetrating the nail plate to relieve the pressure. After having the pressure relieved, make sure you are extra cautious about keeping your toes from suffering trauma during recovery, and make sure you wear shoes that do not expose the affected toe (i.e. do not wear sandals or flip-flops).  

If you have recently suffered a trauma to your toes, are suffering from throbbing pain in your toes, and are concerned about a hematoma, please do not hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona, and have all your treatment options presented to you.

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