Subungual Hematoma NOT drained/threphined - nail deformity?

[BlackFinger007]

Two months ago (11 weeks to be precise) I crushed my middle finger in a door.  (The nail was intact and both sides still attached, it just received a crush injury down at the lunar/growning end).  I had it Xrayed which ruled out any fracture but nothing else was done.  Approximately 50% of the nail went black.

I now know that the hematoma should have been drained ('trephination'?) and/or the nail removed to repair any nail bed lacerations.  Neither of these was done.

Now the blackened nail is significantly raised compared to its healthy neighbours (probably due to the build up of now-dried up blood underneath) and it is growing out. (It is not raised in a regular way, it is more raised on one side)

But what worries me is that the new nail underneath appears to be growing in a different shape.  It is more curved (from left to right, not from fingertip to joint).  I have read that sometimes crush injuries result in permanent nail deformity.

My question is this:  since it is obviously now to late for trephination, is there anything I can do to avoid permanent nail deformity, for cosmetic reasons?  Should I have the blackened nail removed so that the new nail can finish growing without the pressure from above distorting it into a funny shape, a funny shape which might then remain imprinted forever?  Is there anything else that can be done?

I would be very grateful for any advice because I would hate to miss any opportunity to prevent nail deformity.
Many thanks

[Bhupinder Kaur, MD]

Hello,
For the subungual hematoma, trephining needs to be done along with removal of the nail. then the new nail which grows will be do so in a healthier pattern and cause less distorted shape.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[hmf099]

I would definitely check with my dr to see if I could avoid nail deformity. I slammed my pinkie in the car door 8 years ago and lost my nail. It now grows in sort of like 2 half nails overlapping. It's not obvious unless I point it out, but it bugs me knowing its like that. Check with ur dr and goodluck!