RT Book, Section
A1 Mayeaux, Jr., E.J.
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164348493
T1 Subungual Hematoma
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK dermatology.mhmedical.com/content.aspx?aid=1164348493
RD 2024/04/24
AB A  22-year-old  woman  dropped  an  iron  on  her  toe  the  day  before  she  visited  our  free  clinic.  Her  toe  was  painful  at  rest  and  worse  when  walking  (Figure  204-1).  This  subungual  hematoma  needed  to  be  drained,  and  we  did  not  have  an  electrocautery  unit.  A  paperclip  was  bent  open  and  held  in  a  hemostat  and  heated  with  a  torch.  With  some  pressure  it  pierced  the  patient's  nail  plate  and  the  blood  spontaneously  drained  (Figures  204-2  and  204-3).  This  relieved  the  pressure  and  gave  the  patient  immediate  pain  relief.  The  remaining  old  blood  was  drained  with  a  little  pressure  on  the  proximal  nail  fold  (Figure  204-4).  Although  we  were  concerned  about  a  possible  underlying  fracture,  the  patient  did  not  have  health  insurance  and  chose  to  postpone  an  X-ray.  Her  toe  healed  well  and  no  radiographs  were  ever  taken.  (Story  by  Richard  P.  Usatine,  MD.)