Sometimes It’s Subungual

As you may have noticed, we have really put a finger on figuring out paronychia and the dreaded felon in the past two Procedural Pause blogs. This series, however, would not be complete without also touching upon complications related to a subungual hematoma and abscess. Hopefully, this month’s entry will point you in the right direction if you come across these two culprits.     Typically, a subungual hematoma will form from direct blunt trauma to the fingernail itself. Some common mechanisms of trauma range from slamming the digit in a car door, in a drawer, hitting it accidentally with a hammer, or from a sports-related injury. Regardless of the mechanism, the complication remains the same; blood collects under the nail causing increasing pain from the building pressure. Usually the nail itself fares well, but even just a small accumulation of blood under the nail causes intense throbbing pain. Draining the subungual blood immediately relieves pain and helps preserve the integrity of the nail.   A subungual abscess is a party gone wrong between the nail plate and the nail bed. It may form as a complication to a paronychia. If you suspect an abscess, most likely there will be pus within the eponychium as well. Please see the previous blog regarding paronychia treatment.   Recognition and treatment of a subungual complication is a great example of a procedure we can perform for our patients that allows for immediate and satisfying results.   The ApproachTrephination ...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs