subungual hematoma

When a child's finger or thumb gets pinched in a door or some similar injury occurs, bleeding can occur under the nail. This appears as a dark blue-black stain under the nail. If the bleeding is significant enough, the resulting pressure can cause throbbing pain.

The cure for this is simple. A hole is drilled in the nail over the blood clot; the pressure is immediately relieved as a tiny amount of old blood gushes out. This can be done painlessly, since the nail has no feeling, and the blood clot protects the tender nailbed.

The hole can be drilled with a tiny battery operated drill, or burned through the nail with a heated paperclip. I have a battery operated device in the office that works wonderfully.

A similar situation of pressure and pain can occur with an infection that causes pus to accumulate under a nail. The cure is the same.

The dark blood stain under the nail will eventually grow out and disappear. Figure that nails grow about 3/8 of an inch or so each month - that will give you some idea how long it will take for the stain to disappear.

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