Goals

To relieve the pain and pressure to the nail caused by the collection of blood between the nail bed and nail plate.

Background

Subungual hematoma refers to the collection of blood between the nailbed and the nail plate and typically results from a crushing injury or blunt trauma to the distal aspect of the digit. Patients often present with throbbing pain to their finger or toe and a dark red or black discoloration to the nail. The pain and pressure associated with this condition is quickly relieved by making a hole on the nail plate to release the blood – this is known as trephination. Subungual hematoma drainage is not required if there is no pain.

Contraindications

The following situations may warrant referral:

• displaced fractures
• extensive nail bed injury
• infected wounds
• loss of finger function