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Subungual haematomas: is simple trephining enough?

S Meek1, M White

  • 1Accident and Emergency Department, Frenchay Hospital, Bristol.

Journal of Accident & Emergency Medicine
|July 29, 1998
PubMed
Summary
This summary is machine-generated.

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Simple trephining for subungual haematomas (bleeding under the nail) offers good results for most patients. Poor outcomes are unpredictable, suggesting simple trephining is sufficient treatment.

Area of Science:

  • Trauma surgery
  • Dermatology
  • Orthopedics

Background:

  • Subungual haematomas are common injuries.
  • Nail appearance and function are key outcomes.

Purpose of the Study:

  • Evaluate simple trephining for subungual haematomas.
  • Identify predictors of poor outcomes.

Main Methods:

  • Prospective study of patients with subungual haematomas.
  • Telephone and postal surveys for outcome assessment (5-13 months post-injury).
  • Outcome graded using published criteria.

Main Results:

  • 123 patients (127 haematomas) followed up (74%).
  • 85% reported excellent/very good results; 67% had no abnormalities.

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  • Only 2% had poor outcomes (nail splitting); no correlation with size, fracture, or infection.

    • Conclusions:

    • Simple trephining provides acceptable results for most subungual haematomas.
    • Poor outcomes are unpredictable at presentation.
    • Aggressive surgical intervention is generally unnecessary.