A subungual hematoma (suh-BUN-gwul hee-muh-TOH-muh) is when blood gets trapped under a fingernail or toenail, often due to an injury such as a stubbed toe or a finger slammed in a door. The injured area under the nail bleeds and, as a result, turns a blue-black color. A child with a subungual hematoma might feel a throbbing pain under the nail, which often gets worse as the blood spreads.

The health care provider examined your child's nail to see if it is still intact and if the finger or toe had any other injuries. If the nail itself was severely injured, the health care provider may have removed it. Otherwise, they did a procedure called a trephination (treh-feh-NAY-shen). This involves putting a tiny hole in the nail and draining the blood trapped under it. This relieved the pressure under the nail and helped your child's pain improve quickly.

The health care provider wrapped your child's finger or toe in a bandage. They also might have placed a splint to protect the area if the finger or toe had other injuries.

• Follow the health care provider's instructions for keeping the area clean and replacing the bandage.
• Some drainage of blood from the small hole is normal.
• If your child also has a broken bone or has swelling or pain, placing ice wrapped in a towel over the injury will help the swelling and pain. Hold ice in a towel against the finger or toe for 15–20 minutes every 3–4 hours for the next 48 hours.
• If the finger or toe is swollen, raise it above heart level by propping it up on a pillow as much as possible in the first few days.
• If a splint was placed, follow the health care provider's directions for taking care of it.
• For pain, you may give acetaminophen OR ibuprofen, if recommended by your health care provider.

Your child has:

• pain that's not helped by pain medicine
• blood spreading under the nail again that causes pain
• signs of infection in the area, such as redness, warmth, increased swelling, or drainage of pus
• a fever of 100.4°F (38°C) or higher

What can help prevent future hematomas? Wearing protective gear during sports can help prevent injuries such as hematomas. Kids should pay attention to closing doors and watch for tripping hazards. Make sure your child's shoes fit properly.