Letters to the Editor

Management of Traumatic Subungual Hematoma


Am Fam Physician. 2005 Mar 1;71(5):856.

to the editor: I would like to describe the procedure for traumatic subungual hematoma (see accompanying figure), which I have performed in my office. Management is as follows:

(1) Clean wound with alcohol.

(2) Lightly twist the point of an 18- or 21-gauge needle back and forth between index finger and thumb after positioning over the hematoma.

(3) After about one minute, you will note a small amount of blood at the tip of the needle.

(4) Clean the dust and blood from the nail with alcohol and proceed while positioning a heparinized hematocrit tube adjacent to the needlepoint.

(5) Blood will be extracted by capillary action into the tube.

View/Print Figure


Chromatic nail hematoma release procedure.


Chromatic nail hematoma release procedure.

(6) Change tubes, pressure, and angle of the needle to extract as much blood as possible.

This procedure is relatively painless for your patients.

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This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



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