Finger or Toe Trauma

Injury Definition

Injuries to fingers or toes. The following types of injuries are covered:

1. Cuts, scrapes (skinned knuckles) and bruises: the most common injuries.
2. Jammed finger or toe
   • The end of a straightened finger or thumb receives a blow (usually from a ball)
   • The energy is absorbed by the joints’ surfaces and the injury occurs there (a traumatic arthritis)
   • For jammed fingers, always check carefully that the end of the finger can be fully straightened
3. Crushed or smashed fingertip or toe (e.g. from car door or screen door
   • Usually the last digit receives a few cuts or a blood blister
   • Occasionally the nail is damaged, but fractures are unusual
4. Fingernail injury: If the nailbed is cut, it needs sutures to prevent a permanently deformed fingernail. This is less important for toenails
5. Subungual hematoma (a blood clot under the nail)
   • Usually caused by a crush injury from a door or a heavy object falling on the finger while it is on a firm surface
   • Many are only mildly painful
   • Some are severely painful and throbbing. These need the pressure released to prevent loss of the fingernail and to relieve symptoms
6. Fractures or dislocations

Call Your Doctor Now (night or day) If

• You think your child has a serious injury
• Looks like a broken bone or dislocated joint
• Skin is split open or gaping and may need stitches
• Large swelling is present
• Blood that’s present under a nail is quite painful
• Fingernail is torn from a crush injury or cut
• Dirt or grime in the wound is not removed after 15 minutes of scrubbing
• Finger joint can’t be opened (straightened) and closed (bent) completely
• Toe injury that causes bad limp or can’t wear shoes
• Severe pain
• Age less then 1 year old

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

• You think your child needs to be seen

Parent Care at Home If

• Mild finger or toe injury and you don’t think your child needs to be seen

Home Care Advice for

1. Bruised/Swollen Finger (or toe)
   • Soak in cold water for 20 minutes
   • Give acetaminophen or ibuprofen as necessary for pain relief
2. Superficial Cuts
   • Apply direct pressure for 10 minutes with a sterile gauze to stop any bleeding
   • Wash the wound with soap and water for 5 minutes
   • For any dirt in the wound, scrub gently
3. Jammed Finger (or toe)
   • Caution: be certain range of motion is normal (can bend and straighten each finger)
   • Soak the hand (or foot) in cold water for 20 minutes
   • Give acetaminophen or ibuprofen as necessary for pain relief
   • If the pain is more than mild, protect it by “buddy-taping” it to the next finger
4. Smashed or Crushed Fingertip (or toe)
   • Wash the finger (or toe) with soap and water for 5 minutes
   • Trim any small pieces of torn skin with a scissors cleaned with rubbing alcohol
   • Cover any cuts with an antibiotic ointment and Band-Aid. Change daily
   • Give acetaminophen or ibuprofen as necessary for pain relief
5. Torn Nail (from catching it on something)
   • For a cracked nail without rough edges, leave it alone
   • For a large flap of nail that’s almost torn through, use a sterile scissors to cut it off along the line of the tear (Reason: pieces of nail taped in place will catch on objects)
   • Soak the finger (or toe) for 20 minutes in cold water for pain relief
   • Apply an antibiotic ointment and cover with a Band-Aid. Change daily
   • After about 7 days, the nailbed should be covered by new skin and no longer hurt. A new nail will grow in over 6 to 8 weeks
6. Pain Medicine: Give acetaminophen or ibuprofen as needed for pain relief
7. Call Your Doctor If
   • Pain becomes severe
   • Not using the finger or toe normally after 1 week
   • Your child becomes worse or develops any of the “Call Your Doctor” symptoms