Finger Injury

Symptoms

DEFINITION

• Injury to the skin or nail of the finger
• Injury to a bone, muscle, joint or ligament of the finger

Types of Injuries

• Abrasions or Scrapes: An area of superficial skin has been scraped off. Commonly occurs on the knuckles.
• Cuts and Scratches: Superficial cuts (scratches) only extend partially through the skin and rarely become infected.  Deep cuts (lacerations) go through the skin (dermis).
• Bruises: Bruises (contusions) result from a direct blow or a crushing injury; there is bleeding into the skin from damaged blood vessels without an overlying cut or abrasion.
• Fractures (broken bones)
• Dislocations (bone out of joint)
• Jammed Finger: The end of a straightened finger or thumb receives a blow (usually from a ball). The ligaments and tendons of the finger are stretched and torn.
• Crushed Fingertip: This injury most often results from getting the finger smashed in a car door or from a heavy object falling on the finger (a hammer!). Usually the fingertip receives a few cuts, a blood blister or a bruise. Sometimes the nail is damaged. A fracture of the bone inside the fingertip can occasionally occur.
• Subungual Hematoma (blood under the fingernail): This medical term is applied when a blood clot forms under the fingernail. It is caused by a crush injury to the fingertip. Some subungual hematomas are only mildly painful and blood is typically under less than 50% of nailbed. Others can be severely painful and throbbing, and these may need the pressure released to relieve the pain. The pressure can be released by putting a small hole through the nail.  With larger subungual hematomas, the fingernail will usually fall off. A new nail will grow back in 6 to 12 weeks.
• Torn Nail: From catching it on something.

When are Stitches Needed?

• Any cut that is split open or gaping probably needs sutures (stitches). Cuts longer than 1/2 inch usually need sutures.
• A physician should evaluate any open wound that may need sutures regardless of the time that has passed since the initial injury.

See More Appropriate Topic (instead of this one) If

• ANIMAL BITE to finger
• BURN of finger
• SPLINTER OR SLIVER in finger
• PUNCTURE WOUND to finger

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for a Sprain of the Finger:

• Remove any rings or jewelry from the injured finger.
• Tape the injured finger to the finger next to it (this is called a buddy splint).
• Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

FIRST AID Advice for Suspected Fracture or Dislocation of the Finger:

• Remove any rings or jewelry from the injured finger.
• Tape the injured finger to the finger next to it (this is called a buddy splint).
• Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

FIRST AID Advice for Transport of an Amputated Finger:

• Briefly rinse amputated part with water (to remove any dirt).
• Place amputated part in plastic bag (to protect and keep clean).
• Place plastic bag containing part in a cup of ice water (to keep cool and preserve tissue).

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

HOME CARE ADVICE FOR MILD INJURIES OF FINGER

1. Treatment of Cuts, Scratches and Scrapes (abrasions):
   • Apply direct pressure for 10 minutes to stop any bleeding.
   • Wash the wound with soap and water for 5 minutes.
   • Scrub out any dirt gently with a washcloth.
   • Cut off any pieces of dead loose skin using fine scissors (clean scissors with rubbing alcohol before and after use).
   • Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily.
2. Treatment of Bruised Finger: Soak the finger in cold water for 20 minutes.
3. Treatment of Jammed Finger:
   • Caution - Be certain range of motion is normal (can bend and straighten each finger).
   • Soak the finger in cold water for 20 minutes.
   • If the pain is more than mild, protect it by "buddy-taping" it to the next finger
4. Treatment of Smashed or Crushed Fingertip:
   • Apply an ice bag to the area for 20 minutes.
   • Wash the finger with soap and water for 5 minutes.
   • Trim any small pieces of torn dead skin with a scissors cleaned with rubbing alcohol.
   • Cover any cuts with an antibiotic ointment and Band-Aid. Change daily.
5. Treatment of Subungual Hematoma (blood under the nail): Apply an ice bag to the area for 20 minutes.
6. Torn Nail (from catching it on something):
   • For a cracked nail without rough edges, leave it alone.
   • For a large flap of nail that is almost torn through, use a sterile scissors to cut it off along the line of the tear (Reason: pieces of nail will catch on objects and tear further).
   • Apply an antibiotic ointment and cover with a Band-Aid. Change daily.
   • After about 7 days, the nail bed should be covered by new skin and no longer hurt. It takes about 6-12 weeks for a fingernail to grow back completely.
7. Pain Medicines:
   • For pain relief, take acetaminophen, ibuprofen or naproxen.
   • Acetaminophen (e.g., Tylenol):
     • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.
     • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.
     • The most you should take each day is 3,000 mg.

   • Ibuprofen (e.g., Motrin, Advil):

     • Take 400 mg by mouth every 6 hours

     • Another choice is to take or 600 mg by mouth every 8 hours.

     • Use the lowest amount that makes your pain feel better.

   • Naproxen (e.g., Aleve)

     • Take 250-500 mg by mouth every 12 hours.

     • Use the lowest amount that makes your pain feel better.

   • Extra Notes

     • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An overdose can hurt the liver.

     • Before taking any medicine, read all the instructions on the package.

8. Call Your Doctor If:
   • Cut or scrape looks infected (redness, red streak or pus)
   • Pain becomes severe
   • Pain does not improve after 3 days
   • Pain or swelling lasts more than 2 weeks
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Photo Example

First Aid - Bleeding Finger

First Aid - Removing a Splinter

You can remove splinters, larger slivers, and thorns with a needle and tweezers. Check the tweezers beforehand to be certain the ends (pickups) meet exactly. (If they do not, bend them.) Sterilize the tools with rubbing alcohol or a flame.

Clean the skin surrounding the sliver briefly with rubbing alcohol before trying to remove it. Be careful not to push the splinter in deeper. If you don't have rubbing alcohol, use soap and water, but don't soak the area if FB is wood (Reason: can cause swelling of the splinter).

Remove the splinter:

• Step 1: Use the needle to completely expose the large end of the sliver. Use good lighting. A magnifying glass may help.
• Step 2: Then grasp the end firmly with the tweezers and pull it out at the same angle that it went in. Getting a good grip the first time is especially important with slivers that go in perpendicular to the skin or those trapped under the fingernail.

Source: LMS Inc.

Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.