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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.

If not, see these topics

• ANIMAL BITE to finger

• BURN of finger

• SPLINTER OR SLIVER in finger

• PUNCTURE WOUND to finger

First Aid:

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).

When to Call Your Doctor

Call 911 Now (you may need an ambulance) If

• Major bleeding (actively bleeding or spurting) that can't be stopped

• Finger has been partially or completely amputated

• Note: For bleeding, see First Aid

Call Your Doctor Now (night or day) If

• You think you have a serious injury

• Injury looks like a dislocated joint (crooked or deformed)

• Bleeding that hasn't stopped after 10 minutes of direct pressure

• Cut or scrape is very deep (e.g., can see bone or tendons)

• Skin is split open or gaping and may need stitches

• Blood present under the nail is causing severe pain

• Fingernail is torn-off or partially torn from a crush injury or cut

• Dirt or grime in the wound is not removed after 15 minutes of scrubbing

• High pressure injection injury (e.g., from paint gun, usually work-related)

• Fingernail is completely torn off

• Base of fingernail has popped out from under skin fold

• Cut or scrape looks infected (redness, red streak or pus)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think you need to be seen

• Finger joint can't be opened (straightened) and closed (bent) completely

• Cut or scrape and it has been more than 10 years since last tetanus booster (5 years for dirty cuts and scrapes)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

• Injury interferes with work or school

• Injury and pain have not improved after 3 days

• Injury is still painful and swollen after 2 weeks

Self Care at Home If

• Minor finger injury and you don't think you need to be seen

HOME CARE ADVICE FOR MILD INJURIES OF FINGER