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Your finger is NOT a door stopper!

“Trephination might be the most fantastic word on the planet.”

“My child’s finger just got shut in the door!”

What do these two sentences have in common, you ask? Let’s find out.

A few situations can occur when a finger gets shut in a door…

1. A bruise. Hurts, and but not the biggest deal ever. And gets better. Ice and elevation is key in this scenario.
2. A broken finger. Usually needs to be buddy taped or splinted, and will also improve over time. Won’t hurt ya to see your doctor for this.
3. A subungual hematoma (blood trapped under the nail). Lots of throbbing pain with this injury as blood spreads underneath the nail.

Let’s talk more about #3.

If the nail is intact, and there’s a significant collection of blood trapped underneath, then a medical provider will perform a procedure called trephination (Feel free to say this 3 times in a row). This procedure involves making a small hole (sometimes multiple holes) in the nail, allowing for release of trapped blood. Drainage of the trapped blood will relieve pressure under the nail and resolve the associated pain. The pressure needs to be relieved or else the nailbed can sustain permanent damage.

The simplest and safest way to make a hole in the nail is to use electric cautery.

Sounds a little scary, right? It’s not. It’s like a hot zapper. The cautery will melt the nail but prevents further nailbed injury as its tip becomes cool when it comes in contact with the trapped blood. Another popular method involves twirling a hollow needle back and forth while applying light downward pressure. This method will also allow for release of trapped blood underneath the nail. After this is done, basic wound care is all that’s required for full recovery. It’s a quick procedure, and typically tolerated quite well. The best news? We can do all of this at PM Pediatrics. Followed by a lollipop  emoji winkemoji lollypop

Now, are you on board here that TREPHINATION might be the most fantastic word on the planet? Or maybe at least in the top 5…add this to my list of 25cent words!



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