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Nail injuries

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Home treatments for a nail injury

A minor knock to a finger or toenail may be no more than an inconvenience, but for painful or torn nails providing treatment can ease pain, speed up healing and prevent infection. Depending on the nail injury, try the following:

  • If the injury is painful, apply ice to the injured nail and keep it elevated.
  • If there is bleeding, use a clean cloth to apply direct pressure; clean the damaged nail area with soap and warm water, apply an antiseptic ointment and wrap it in a plaster. Change the plaster daily.
  • If the nail is loose, torn or separating from the nail bed, trim it to where it is attached to the nail bed to prevent further trauma. Do not pull at the nail to try to remove it from the nail bed.
  • Take over-the-counter paracetamol or ibuprofen if needed to reduce pain.

It can take about a week for pain and swelling to go down.

When to seek medical help

You should seek medical advice if a bruise covers more than one quarter of the nail and you want it drained or if you think there is an infection. Signs of an infection include redness, heat around the nail, a red streak extending from the injury or pus.

If a subungual haematoma is involved and more than 25% of the nail is black and particularly painful, and if the injury is new - while the blood is still liquid - your doctor can make a small hole in the nail to drain the blood and release the pressure; this procedure, known as trephining, is painless and takes only a few seconds using a heated wire device.

The blood may push the nail away from the bed, causing it to fall off after a few weeks. Regardless of the reason for a detached nail, as long as the nail bed isn't damaged, a new nail will grow in to replace the old one. If a toenail falls off, wear shoes that won't put pressure on the new growing nail to prevent it becoming an ingrown toenail.

If the nail or nail bed has a serious cut or has been amputated, or if a fingertip is bent or deformed enough to indicate a broken bone, go to the A&E department of your local hospital. An amputated part should be wrapped in moist clean kitchen paper, put into a clean polythene bag, then put into a bag with ice, while the injured finger or toe should be wrapped in a clean towel.

To avoid nail deformities, sometimes the nail bed is repaired under either local or general anaesthesia. The nail may be removed to reach the nail bed, which is then repaired using fine stitches called sutures. The nail may be replaced to protect the repair, or sometimes a piece of sterile foil is used instead.

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