Managing Finger Injuries: What to Expect After a Door Slam

Q: Managing Finger Injuries: What to Expect After a Door Slam

Hello： If the pain is severe, it is best to consider bloodletting measures to relieve pressure and allow the pain to improve naturally. <br>If the pain is not perceived as severe, it should gradually lessen over time. <br>However, it is important to rule out the possibility of a

The index finger was pinched by a car door (contusion)?

Hello, Doctor Huang: Two days ago, my index finger got caught in a car door, and about two-thirds of the nail is bruised.
After two days, when I bend or extend my finger, I feel a tingling sensation in the last segment of my index finger, and sometimes there is a sharp pain behind the nail, likely at the site where it was pinched.
The nail has not lifted.
Today, I went to see a surgeon, who suggested that I should have the nail removed for quicker recovery, but I heard that nail removal is very painful (even with anesthesia), so I hesitated and chose to let it fall off on its own since I no longer feel the pain from the day it was pinched.
Doctor, how long will it take for the nail to fall off on its own if I don't have it removed? Will the new nail grow from the root, or will it grow in layers, pushing the old nail up and causing it to fall off? If I don't have it removed, will it continue to hurt until it falls off? After my finger was pinched, I feel pain behind the nail; will that get better in a few days?

Xiao Yu, 30~39 year old female. Ask Date: 2005/07/11

Dr. Huang Junxiong reply Surgery

Hello: If the pain is severe, it is best to consider bloodletting measures to relieve pressure and allow the pain to improve naturally.
If the pain is not perceived as severe, it should gradually lessen over time.
However, it is important to rule out the possibility of a distal phalanx fracture, as the pain from a fracture may persist for a longer duration.
As for when the nail will fall off and how it will detach, this depends on the condition of the hematoma beneath the nail and the injury to the nail bed.
Generally, it may take several months, and during this process, the nail may become loose.
At this point, it is necessary to trim the nail appropriately or even have a physician remove the nail if it is nearly completely detached from the nail bed, as this will help prevent pain caused by the nail being lifted.
Wishing you good health.

Reply Date: 2005/07/11

More Info

When dealing with finger injuries, particularly those caused by slamming a door, it's essential to understand the healing process and what to expect. In your case, it sounds like your finger sustained significant trauma, resulting in bruising beneath the nail and some discomfort. Here’s a detailed overview of what you can expect and how to manage your injury.

Understanding Your Injury
1. Bruising and Pain: The bruising you see under your nail (subungual hematoma) is a result of blood pooling due to the trauma. This can cause pain and pressure, especially when bending or straightening the finger. The "tingling" or "numb" sensation you feel in the last segment of your finger is likely due to nerve irritation or damage from the injury.

2. Nail Health: If the nail is intact and not lifted, it may heal without needing to be removed. However, if the nail is severely damaged or if there is significant pressure from the blood beneath it, removal might be necessary to relieve pain and allow for proper healing.

Healing Process
1. Self-Healing: If you choose to let the nail fall off naturally, it can take several weeks to months for the nail to loosen and eventually detach. The timeline varies depending on the severity of the injury and individual healing rates. Typically, if the nail is not removed, it may take anywhere from 4 to 6 weeks for the nail to loosen enough to fall off.

2. Nail Growth: Once the nail falls off, a new nail will begin to grow from the nail matrix (the area under the cuticle). This new nail will grow out from the base, pushing the old nail upwards. The new nail may initially appear thinner or softer and will gradually thicken as it grows out.

3. Pain Management: It’s common to experience some discomfort as the nail grows out, especially if there is still bruising or if the nail bed is sensitive. Over-the-counter pain relievers can help manage this discomfort. If the pain persists or worsens, it’s crucial to consult a healthcare professional.

When to Seek Medical Attention
- Persistent Pain: If you experience ongoing pain that does not improve or worsens over time, it’s advisable to seek medical evaluation. This could indicate complications such as infection or more severe damage to the underlying structures of the finger.

- Signs of Infection: Watch for signs of infection, such as increased redness, swelling, warmth, or pus around the nail or finger. If these symptoms occur, you should see a doctor promptly.

- Nail Changes: If the nail does not grow back properly or if you notice any unusual changes in the nail's appearance, such as discoloration or deformity, follow up with a healthcare provider.

Conclusion
In summary, while it can be concerning to deal with a finger injury from a door slam, many cases heal well with time and proper care. Allowing the nail to fall off naturally is a valid option, but be mindful of your symptoms and seek medical advice if you have any concerns. Remember to keep the area clean and protected, and consider using ice to reduce swelling and pain in the initial days following the injury. If you have any doubts about your recovery or the condition of your finger, don’t hesitate to consult a healthcare professional for personalized advice.

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