Medical Treatment
When the pain caused by a hematoma becomes unbearable despite simple treatment, there are two main options: draining the blood or removing the entire nail to relieve the pressure underneath. To drain the blood, a procedure called trephining is performed, which involves creating one or more small holes above the hematoma to allow the blood to escape. This procedure can be carried out using tools such as a drill, cautery, scalpel, or, in some cases, a laser.
In cases where the nail is severely damaged or there are lacerations around the area, complete removal of the nail may be necessary. Depending on the severity of the condition and the treatment plan, doctors may administer a digital nerve block or local anesthesia to ensure a painless removal of the nail.
Prevention
Avoiding subungual hematomas, which are typically minor injuries, can be achieved through simple safety measures. For instance, individuals working in environments where accidental blows to the fingers and toes are common should consider wearing steel-toed boots. Similarly, those who experience hematomas due to ill-fitting running shoes can prevent them by ensuring proper shoe fit. Inserting silicone toe protectors into athletic shoes may also provide extra protection. Additionally, keeping toenails trimmed short can help reduce the risk of excessive pressure on the nail and nail bed.