Nail Bed Injuries of the Hand | Orthopaedics | Loyola Medicine

Nail Bed Injuries of the Hand

Overview and Facts about Nail Bed Injuries of the Hand

A nail bed injury of the hand may be present when you hurt any part of your fingertips. Depending on the severity of the injury, pain might prevent you from using your fingers. Common types of nail bed injuries include:

  • Subungual hematoma, or blood trapped beneath your nail
  • Nail bed laceration, or slicing the nail and the nail bed
  • Nail bed avulsion, when the nail and nail bed separate from the finger
  • Fingertip fracture, which is a break in the small bone at the tip of your finger

Most nail bed injuries occur because of an accident or impact. However, with the right treatment, your finger can heal and return back to normal.

Signs and Symptoms of Nail Bed Injuries of the Hand

Regardless of the type of nail bed injury you have, you might experience a lot of pain that limits the use of your fingers and prevents you from engaging in ordinary tasks, such as typing on a computer or holding certain objects.

Your nail might be cut or damaged, with blood welling up and collecting under it. In many cases, the nail actually falls off and regrows over the next three to six months. In some cases, your nail might grow back deformed.

Causes and Risk Factors of Nail Bed Injuries of the Hand

Common ways to sustain a nail bed injury include slamming your finger in a car door or dropping a heavy object on your hand. Other causes might involve:

  • Hitting your finger with a hammer
  • Cutting your fingertip with a knife
  • Colliding with another player while playing sports

Like many orthopaedic conditions, risk factors for nail bed injuries include engaging in an active or labor-intensive lifestyle, such as those associated with being an athlete or carpenter.

Tests and Diagnosis of Nail Bed Injuries of the Hand

Your doctor can diagnose a nail bed injury with a simple examination of your hand. After cleaning up any blood, they gently look at the finger to determine the extent of the damage.

In some cases, the doctor might use an X-ray to check for broken bones. Having a clear view of a broken bone allows the doctor to set the bone so your finger can heal correctly.

Treatment and Care for Nail Bed Injuries of the Hand

For many nail bed injuries, your doctor will drain any blood collected under the surface of the nail by drilling a small hole in the nail. This procedure also relieves the pressure and pain associated with the injury.

For more serious injuries, your doctor might need to split the finger or perform surgery. Surgeries for nail bed injuries involve removing part of the nail and trimming the tissue that your nail sits on to help your nail grow back normally. It may also be necessary to remove all of the existing nail along with any scar tissue so that a new nail can grow uninhibited.