Smashed fingers

Considerations

If an injury to a finger occurs at the tip and does not involve the joint or nail bed, you may not need the help of a doctor. If the tip of your finger bone is broken, your doctor may not recommend a splint.

If the injury is more toward the palm or involves the joint, seek medical help right away.

Causes

Finger(s) can be smashed by a hammer blow, a car door, a desk drawer, a baseball, or some other force.

Symptoms

• Difficulty moving the tip of the finger
• Discoloration or bruising of the finger or fingernail
• Finger pain
• Loss of fingernail
• Swelling

First Aid

Apply an ice pack to decrease swelling. Over-the-counter pain medicines may help relieve discomfort.

If pain becomes severe, with blood under the fingernail, talk to your health care provider. Your health care provider may guide you in taking the following steps to relieve the pressure and prevent the fingernail from falling off.

• Unbend a metal paper clip (or a similar size metal wire).
• Heat the end of the paper clip over an open flame until it is red hot. Use a pair of pliers to hold the paper clip. While it is still very hot, touch the tip of the paper clip to the injured fingernail. Touch the nail over where the blood is collected. This is not a painful procedure for most people.The heat of the clip will burn a small hole in the fingernail. It is not necessary to press hard on the fingernail to burn the hole.
• As the paper clip is removed, blood should start releasing through the small hole. If not, do the procedure again until blood comes out.
• Pain will be relieved as the pressure is released. Keep the finger dry for 2 days.

This procedure can be repeated if the hole closes over and the pressure rebuilds.

Wash the finger carefully before and after the procedure. Seek medical help if the crush area is very dirty, if the procedure does not work, or if the finger looks like it might be infected. You may need antibiotics.

DO NOT

• Do not splint a smashed finger without first consulting your health care provider.
• Do not drain a swollen finger unless your health care provider instructs you to do so.

When to Contact a Medical Professional

Seek medical attention right away if the finger is bent or if the injury involves more than the tip of the finger.

Prevention

Teach safety to young children. Use caution when shutting doors to make sure fingers are not in danger.

Alternative Names

Finger(s) - smashed; Crushed digits

References

Lyn ET, Mailhot T. Hand. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Elsevier Mosby; 2009:chap 47.

Butler KH. Incision and drainage. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Elsevier Saunders; 2009:chap 37.

Update Date: 4/16/2013

Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.