When doing home repairs, hanging a picture or building something in your workshop, you may accidentally hit your finger with the hammer. This is a fairly common accident, but it is very painful and could even damage your finger if you put in a lot of force. In this case, you need to evaluate the damage to understand how to proceed with a home treatment or to decide whether to go to the emergency room. You can make your choice by observing the injury and weighing the severity of the situation.
Steps
Method 1 of 3: Taking Care of the Finger
Step 1. Check for swelling
Your finger will likely swell, no matter how hard you hit it. This is the most common reaction to this type of trauma. If the impact was not too severe, the finger may only be swollen for a couple of days. If you have no symptoms other than swelling, put an ice pack on your finger to reduce it and control the pain.
- You can also take an over-the-counter pain reliever to find some relief.
- An NSAID (non-steroidal anti-inflammatory) such as ibuprofen (Moment, Brufen) or naproxen sodium (Momendol, Aleve) can manage inflammation and discomfort. Take it according to the instructions on the package.
- You don't have to go to the doctor unless the swelling goes away, you experience severe pain or numbness, or you can't move your finger at all.
Step 2. Manage a fracture
If the swelling is really very severe and you are in extreme pain, you may have suffered a fracture, especially if you hit your finger very hard. If the finger is deformed and very painful to touch, it is likely broken. This injury could be accompanied by bleeding or a pinched toenail.
If you are concerned that you have fractured your finger, go to the emergency room. You will need to have an x-ray and your doctor will apply a splint or proceed with another type of treatment. Don't use a splint on your own unless your doctor prescribes it
Step 3. Clean the wound
If there is blood loss as a result of the accident, you need to wash the wound to establish the damage. If you notice bleeding, wash your finger under warm running water, making sure that the water does not flow back into the wound, but flows down the drain. Then clean the damaged surface with gauze and a disinfectant such as Betadine.
- Apply pressure to the wound for a few minutes to slow blood flow; in this way, you can assess the depth of the lesion and determine if medical intervention is necessary.
- If the bleeding is heavy or the blood is gushing, go to the emergency room right away.
Step 4. Check for tears
When you have cleaned the wound, you need to evaluate the condition of the finger for lacerations or cuts. There may still be a slight bleeding, but this is completely normal. The lesions often have the appearance of tears or flaps of skin on the surface of the finger. You should have your doctor examine any wounds with clearly destroyed tissue or torn skin, which leaves the finger flayed and bleeding. Tears need stitches when they are 1.5 cm or larger. However, if a part of the skin is completely destroyed, there is little chance of saving it.
- Many doctors suture damaged or torn skin over the flayed fingertip waiting for the new one to grow so that you can remove it when the injury has healed.
- The lacerations can be shallow and stop bleeding rather quickly, especially if the impact was not very strong. In this case, wash the wound, apply antibiotic ointment and wrap your finger in a bandage.
Step 5. Check for tendon damage
Because the hand and fingers have an intricate system of tendons and nerves, it is important to examine the injury for signs of tendon damage. The tendons are structures that connect the bones to the muscles and the hand has two types: the flexors, which are located on the palm and allow the fingers to be bent, and the extensors, which are located on the back and allow the opposite movement. Cuts and crush injuries can damage or even sever them.
- A cut or torn tendon prevents bending of the finger.
- If you see a cut in the palm of your hand or near a skin fold in the knuckles, it could indicate damage to the underlying tendon.
- You may also feel numbness due to related nerve damage.
- Pain in the palm could also be a sign of a tendon injury.
- In these cases, surgery may be required, as repairing an injury to the hand and fingers is a very complex process.
Step 6. Assess the condition of the nail
If you hit it with the hammer, it could be badly damaged. Observe it to determine the situation. If there is a small blister filled with blood under it, you don't have to go to the doctor. Simply apply the ice pack and take over-the-counter medications to manage the initial pain. If the pain lasts a few days, the blood blister occupies more than 25% of the nail surface or causes a strong pressure under it, go to the emergency room; it is probably a subungual hematoma.
- You may also notice that a portion of the nail has come off or cut off. If you have a major wound on your nail bed, go to the emergency room as you will likely have stitches applied to it. If you don't take care of the injury, cutting it could prevent the new nail from developing, deform it, or become infected.
- If your nail has partially or completely detached, go to the hospital right away. This is a serious problem that must be handled professionally. The nail may be removed entirely or sutured in place until the new, healthy one grows back. This process also takes up to two months.
Method 2 of 3: Treating a Subungual Hematoma
Step 1. Go to the doctor
If the accumulation of blood under the nail is severe, i.e. it takes up more than 25% of the nail surface, you need medical attention. In this case, it is a subungual hematoma, an area of small broken blood vessels under the nail. Your doctor will likely recommend that you drain the blood.
- If blood stagnation occupies no more than 25% of the nail, then you don't need to do anything. The blood will be reabsorbed and will disappear on its own as the nail grows.
- If the hematoma is larger than 25% of the nail, x-rays are needed.
- You should go to a doctor or emergency room within 24 to 48 hours to have this injury treated.
Step 2. Undergo blood drainage in the doctor's office
The safest way to extract it is to have a doctor perform a cauterization drain. During the procedure, a small hole is made in the nail by fusing it thanks to an electric cautery. When the tip of the instrument reaches the blood, it automatically cools, thus avoiding possible burns.
- Once the hole is made, blood flows out of the nail until the pressure is reduced. When finished, the doctor will apply a dressing to your finger and allow you to go home.
- Alternatively, drainage with a sterile 18 gauge needle is performed, although cauterization is usually preferred.
- The surgery does not cause pain because the nail is not innervated.
- This procedure relieves the pressure that has built up under the nail, reducing the chances of having to remove it.
Step 3. Get rid of the hematoma at home
Your doctor may authorize you to drain your blood at home. If so, take a paper clip, lighter and wash your hands with great care. Prepare the paperclip by opening it and placing the straight end over the lighter flame. Wait for the metal to get hot, it will take about 10-15 seconds. Take the paper clip and place the red-hot tip on the center of the hematoma, waving it over the same spot to punch a hole in the nail. When you pierce the thickness of the nail, the blood begins to flow out by itself. Take a cloth or gauze to wipe off the blood as it drains.
- If you can't puncture the nail on the first try, re-heat the paper clip and try again, this time pressing harder to go through the thickness.
- Do not apply too much pressure, because you don't have to prick the nail bed.
- You can take a pain reliever before starting the procedure if you are in a lot of pain.
- If you can't pierce your nail on your own, ask a trusted friend or family member to help you.
Step 4. Clean the nail once more
When all the blood has come out, you need to clean it again. Always use a disinfectant, such as Betadine or a cleaning solution, and bandage your finger with a bandage, creating a ball of gauze over the nail. In this way, you cushion and protect the area from external irritants and further trauma. Secure the bandage with medical tape.
You can possibly anchor the bandage by wrapping it with an "8" movement, which goes from the finger to the base of the hand; this way, you can be sure the bandage stays in place
Method 3 of 3: Continue to Care for Your Finger
Step 1. Change dressings
Regardless of the type of damage you have suffered or the injury you have sustained, you need to change the bandage once a day. However, replace it immediately if it gets dirty before 24 hours have passed. When you remove the dressing daily, clean the nail with a sterile solution and apply the new bandage as you did before.
If you have stitches, ask your doctor for more details before cleaning them. Follow her instructions regarding wound care. You will likely need to keep the suture clean and dry without any cleaning solution
Step 2. Monitor for signs of infection
Every time you remove the gauze, look at the nail for any infections. Check for pus, discharge, redness, or warmth, especially if it spreads to your hand or arm. Also take note if you start to have a fever, as various complications can develop, including infections such as cellulitis, paronychia and other hand conditions.
Step 3. Go to the doctor for checkups
A few weeks after the injury, he returns to the doctor. If stitches have been applied or a hematoma drainage has been performed, you will likely be scheduled for a follow-up appointment. However, always go back to the doctor for a final evaluation when you experience trauma like this.
- Remember to call your doctor if you experience additional symptoms, if you think an infection has developed, or if dust or dirt has entered the wound that you cannot remove. You should also get in touch with him if you experience excessive pain, if it has increased or if uncontrollable bleeding starts.
- Don't hesitate to go back to the doctor if you experience symptoms of nerve damage, such as loss of sensation, numbness, or the development of a ball-shaped scar, called a "traumatic neuroma," which is often painful and causes an electrical sensation when touched.
