Nail Bed Injury

The nail bed is the soft tissue under the nail. This tissue includes the growth center of the nail. If this growth center is damaged, the nail may not grow back normally. It can take several months for an injured or torn off (avulsed) fingernail or toenail to regrow. The regrown nail might have an abnormal shape or appearance.

DIAGNOSIS

  • Tell your caregiver exactly how your injury occurred.

  • Tell your caregiver if you think there is a splinter (wood, metal, glass) in your finger or toe or under the nail.

  • Tell your caregiver about any other medical problems you have (especially diabetes or peripheral vascular disease). Tell them also about any medications you take.

  • In addition to examining your injury, your caregiver may need to check for diabetes, nerve problems or poor circulation.

  • Nail bed injuries can involve the bone in the tip of your finger or toe. X-rays may be needed to see if you have a fracture.

TREATMENT

Your nail bed injury may be treated in several different ways.

  • You may not require any special treatment other than keeping the area clean and free of infection.

  • You may require removal of a blood clot under the nail. This can often be a very simple procedure.

  • You may need part of your nail removed. This might be necessary to suture any cut (laceration) in the nail bed. Sometimes the avulsed nail is stitched back in place to provide temporary protection to the nail bed until the new nail grows in.

  • For certain injuries, your caregiver may direct you to see a hand specialist.

HOME CARE INSTRUCTIONS

  • Keep your hand or foot elevated to relieve pain and swelling.

  • For your foot, this will require lying in bed or on a couch with the leg on pillows or sitting in a recliner with the leg up. Walking or letting your leg dangle may increase swelling, slow healing and cause throbbing pain.

  • For your hand, this will require elevating your hand above the level of your heart. Use pillows on a table or the arm of your chair while sitting, and on your bed while sleeping.

  • Keep your injury protected with bandages or splints as recommended.

  • Keep your bandage dry and clean. Change your bandage as directed by your caregiver.

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • See your caregiver as needed for problems.

SEEK MEDICAL CARE IF:

  • You have pain that is not controlled by your medication.

  • You have any problems caring for your injury.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have increased pain, swelling, inflammation (redness & warmth), drainage or bleeding.

  • An oral temperature above 102° F (38.9° C) develops, not controlled by medication.

  • You have swelling which spreads from your finger into your hand, or your toe into your foot.