Toe Trauma

Subungual Hematomas

Let me guess … you dropped something on your toe? … or stubbed it on a piece of furniture? Fortunately, after the inital pain, these clumsy little mishaps generally cause no further discomfort. However, sometimes the trauma will cause painful bruising (subungual hematoma) under a nail.

Subungual hematomas usually occur as a result of trauma or jamming. Jamming is seen a lot in athletes and can be called “runner’s toe”. The injury causes blood to pool underneath the nail between the nail plate (your actual nail) and the nail bed (the soft tissue the nail plate attaches to). Just a small portion of the nail can be involved or the entire nail can become bruised.

The underlying bruising can cause infection or pain. Subungual hematomas that are painful or affect greater than 50% of the nail should be removed so that a new nail can grow in without issue. When the nail is not removed a new nail will grow in causing the old, bruised nail to become loose and fall off on its own. If a high force trauma occurred there may even be an underlying fracture of the bone and should be ruled out through an x-ray.

A new nail will take up to 6-12 months to come in. So unfortunately, it is going to be a while before your toe looks normal again.

Remember that no foot pain is normal!

If you’ve developed bruising under your nail and are concerned please give us a call (or Appointment Request) for an evaluation today.