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Controlled nail trephination for subungual hematoma.

Sharon A Salter¹, David H Ciocon, Thiruvallur R Gowrishankar

¹Department of Dermatology, Brigham and Women's Hospital, Boston, MA 02115, USA.

The American Journal of Emergency Medicine

|November 14, 2006

Summary

A subungual hematoma, or blood under the nail, can cause severe pain. A novel nail trephination technique offers quick, minimally invasive relief for this painful condition.

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Area of Science:

Orthopedics
Emergency Medicine
Trauma Surgery

Background:

Subungual hematomas result from trauma, causing significant pain due to pressure buildup under the nail.
Effective and minimally invasive drainage is crucial for patient comfort and preventing complications.

Observation:

A 47-year-old male presented with a subungual hematoma of the right thumb following a crush injury.
The patient experienced extreme discomfort due to the accumulated blood under the nail.

Findings:

Controlled nail trephination was performed using a specialized drill, penetrating only the nail plate.
The procedure successfully drained the subungual hematoma, leading to substantial pain relief within 8 hours.

Implications:

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This technique provides a rapid, convenient, and low-risk method for evacuating subungual hematomas.
It offers a promising alternative for managing painful subungual hematomas with minimal patient discomfort.