Injuries of the nail

Injuries of the nail can be caused by crushing, tearing, ripping, slicing or cutting. They can range from bruises beneath the nail to the separation of the nail from the nail bed and may lead to deformity if severe.

The nail consists of a nail bed, nail plate and cuticle. Different areas of the nail can be damaged, and often an injury to the nail involves more than one aspect of the nail. The most common injuries of the nail include:
  • A nail bruise (subungual hematoma) - this is when blood collects beneath the nail, proving to be painful to touch or move.
  • A nail laceration - this occurs when the nail is cut through to the nail bed or cuticle. This can make the nail appear mangled.
  • A fingertip amputation - this occurs when the very tip of the finger, including part or all of the nail, is removed during an accident.
  • A nail avulsion - when the entire nail or portion of the nail is lifted from the nail bed.
  • A fractured bone beneath the nail - this can also cause injury to the nail and lead to a deformity at the end of the finger.
What does treatment involve for a nail injury?

For serious nail injuries, you should visit the emergency room. Treatment of nail injuries will depend on the severity of the injury and what parts of the nail and finger were damaged. X-rays may be taken to look for broken bones that may require treatment. The goal for nail injury treatment is to restore the nail and reduce pain. For a nail bruise, a small hole may be made to allow the fluid beneath the nail to escape and relieve the pressure. If this nail bruise is accompanied by a broken bone in the fingertip, the nail may need to be removed and the nail bed repaired. For nail lacerations and avulsions, cuts into the nail may need to be closed with stitches, or the nail may need to be removed.
More serious nail injuries may require surgery and splinting. Severe injuries may result in a deformed nail.