Management of Traumatic Subungual Hematoma

American Family Physician - Volume 71, Issue 5 (March 2005) - Copyright 2005
American Academy of Family Physicians - About This Journal
Letters to the Editor

Management of Traumatic Subungual Hematoma

TO THE EDITOR:

I would like to describe the procedure for traumatic subungual hematoma (see
accompanying figure), which I have performed in my office. Management is as
follows:

(1) Clean wound with alcohol.

(2) Lightly twist the point of an 18- or 21-gauge needle back and forth between
index finger and thumb after positioning over the hematoma.

(3) After about one minute, you will note a small amount of blood at the tip of the
needle.

(4) Clean the dust and blood from the nail with alcohol and proceed while
positioning a heparinized hematocrit tube adjacent to the needlepoint.

(5) Blood will be extracted by capillary action into the tube.

(6) Change tubes, pressure, and angle of the needle to extract as much blood as
possible.
Figure . (Figure Not Available) Chromatic nail hematoma release procedure.

This procedure is relatively painless for your patients.