Nail Avulsions
What is it? Nail avulsion occurs when the entire nail or a portion of it is torn away from the nail bed.
Causes:
- Trauma such as catching the nail on an object or slamming it in a door.
- Sports-related injuries.
- Accidents during play.
- Artificial nail pulling out the nail.
Symptoms:
- Pain and bleeding.
- Visible separation of the nail from the nail bed.
First Aid:
- Assess the Injury: Check for any other associated injuries. If there's excessive bleeding or the injury seems severe, seek medical attention immediately.
- Clean the Area: Gently clean the injured area with mild soap and water to reduce the risk of infection.
- Apply Pressure: Use a clean cloth or sterile gauze to apply gentle pressure to control bleeding.
- Protect the Area: Avoid bandages that would stick to the wound as it heals - use antibiotic ointment on gauze and wrap with coban or tape. It is okay to stop the ointment when the skin is healed.
- Avoid too much pressure when wrapping the wound.
- Expect oozing for 3-5 days and it will be 2-4 weeks before new nail growth appears.
Follow-up:
- Consult a healthcare professional for further evaluation and treatment.
- In some cases, nail avulsions may require medical intervention such as nail bed repair.
Prevention:
- This injury is commonly associated with artificial nails. We do not recommend artificial nails in children due to high risk of injury.
Hematomas (Blood Under the Nail)
What is it? A hematoma under the nail occurs when blood pools beneath the nail due to injury.
Causes:
- Trauma such as slamming a finger in a door or hitting it with a hammer.
- Sports-related injuries.
Symptoms:
- Pain and tenderness.
- Swelling and bruising under the nail.
- Dark discoloration of the nail.
First Aid:
- Ice Application: Apply a cold compress or ice pack to the injured finger to reduce swelling and pain.
- Elevation: Keep the injured finger elevated to minimize swelling.
- Pain Management: Over-the-counter pain relievers such as ibuprofen can help alleviate discomfort.
- Avoid Pressure: Encourage your child to avoid activities that may put pressure on the injured nail.
When to be seen:
- If there is disfigurement of the area or significant pain, seek medical attention.
- This type of injury can be associated with bone fracture under the nail and should be assessed.
- The medical provider may drain the subungual hematomas that are acute (less than 24 to 48 hours old), are not spontaneously draining (eg, blood oozing around the edge of the nail), are associated with intact nail folds, and painful.
Ingrown Nails
What is it? An ingrown nail occurs when the edge of the nail grows into the skin instead of over it, leading to pain and inflammation.
Causes:
- Improper nail trimming.
- Tight-fitting shoes.
- Trauma to the nail.
Symptoms:
- Pain and tenderness along the edge of the nail.
- Redness and swelling.
- Infection may occur if left untreated.
First Aid:
- Soak the Affected Area: Soak the affected finger or toe in warm, soapy water to soften the nail and reduce inflammation.
- Gentle Trimming: Carefully trim the corner of the ingrown nail straight across to help relieve pressure.
- Keep it Clean: Clean the affected area with mild soap and water, and apply an over-the-counter antibiotic ointment.
- Avoid Tight Footwear: Wear shoes that provide ample room for the toes to prevent further irritation.
- Antibiotics are not generally needed for ingrown nails.
Follow-up:
- If the ingrown nail persists or becomes infected, seek medical attention.
- In severe cases, a healthcare professional may need to remove a portion of the nail.
Prevention Tips:
- Encourage proper nail hygiene and trimming techniques.
- Ensure your child wears properly fitting footwear, especially during physical activities.
- Teach your child about safety measures to prevent traumatic nail injuries.
