Smashed fingers is an injury involving direct trauma to one or more fingers.

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

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

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

• Apply an ice pack to decrease the swelling.
• Over-the-counter pain medications may help relieve discomfort.
• If pain becomes excessive, with blood under the fingernail, talk to your health care provider. Your health care provider may assist you in taking the following steps to relieve the pressure:

1. Heat the end of a bent paper clip (or a similar size metal wire) over an open flame until it is red hot. Use a pair of pliers to hold the paper clip during sterilization.
2. While it is still very hot, touch the tip of it to the injured fingernail. This is not a painful procedure for most people.
3. 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 a hole. (Another technique is to drill a small hole in the nail by twirling a scalpel blade, sharp knife, or needle.)
4. As the paper clip is removed, blood should start releasing through the small hole. If not, retry the procedure until blood comes out and pressure is relieved.
5. The pain will be relieved as the pressure is released. Soak the injured finger in warm water with a few drops of disinfectant for 20 minutes, 4 times a day, for 2 days.
6. This procedure can be repeated, if necessary, if the hole closes over and the pressure rebuilds.
7. Wash the finger carefully before and after the procedure. You may take antibiotics if the procedure was not performed under sterile conditions.

• DO NOT Splint a smashed finger without first consulting your health care provider. You may decrease finger movement.
• DO NOT Try to drain a swollen finger unless your health care provider instructs you to do so.

Call for immediate medical attention if the finger is deformed, or if the injury is not limited to the tip of the finger.

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

Salter SA, Ciocon DH, Gowrishankar TR, Kimball AB. Controlled nail trephination for subungual hematoma. Am J Emerg Med. 2006;24:875-877.