What is the treatment for a subungual hematoma?

The treatment for a subungual hematoma primarily involves nail trephination. This procedure involves creating a small hole in the nail to allow the trapped blood underneath it to escape. The release of this pressure alleviates pain and promotes healing. Subungual hematomas occur due to trauma, leading to bleeding under the nail which can be quite painful due to increased pressure from the accumulating blood.

Nail trephination is preferred because it can be performed quickly in a clinical setting and provides immediate relief to the patient. It is important to relieve the pressure to prevent further pain and damage to the nail bed, which can affect nail growth if not properly addressed.

Other management options, such as warm soaks, elevation, or ice, do not address the underlying issue of the accumulated blood and would not provide relief from the acute pain caused by the pressure of the hematoma. Similarly, nail removal might be considered in more severe cases where the nail is extensively damaged, but it is not the go-to treatment when the objective is to relieve a painful subungual hematoma effectively.