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subungual hematoma
Etiology:
- trauma
Physical examination:
- assessment of motor & sensory function of the affected digits
- range of motion, 2-point discrimination, color, capillary refill
Clinical manifestations:
- throbbing pain may occur due to pressure under the nail
- pigmentation progresses distally as nail grows out creating a zone of clearing between the proximal nail fold & the pigmentation
- surrounding skin changes generally resolve within a few weeks
Management:
- evacuation of subungual hematoma (CPT)
- removal of nail is generally not necessary
- a small hole can be created in the nail to releive pressure
- as cautery device of a heated paper clip will suffice [3]
Related
nail bed laceration
General
hematoma
finger injury
References
- Medical Knowledge Self Assessment Program (MKSAP) 16
American College of Physicians, Philadelphia 2012
- Braun RP, Baran R, Le Gal FA, Dalle S,
Diagnosis and management of nail pigmentations.
J Am Acad Dermatol. 2007 May;56(5):835-47. Epub 2007 Feb 22.
PMID: 17320240
- Cimino-Fiallos N
14 Can't-Miss Hand Emergencies
Medscape. March 5, 2021
https://reference.medscape.com/slideshow/hand-emergencies-6010180