How to Treat a Finger Injured by a Hammer

Have you ever accidentally hit your finger with a hammer while doing household chores, hanging a picture or building something in the workshop? This is a common occurrence, but can be very painful, and your finger will hurt if hit hard. At this point you need to assess the extent of the damage to know how to treat it at home and when to see a doctor. You can decide this by examining the wound and determining its severity.

Table of Contents

Finger care

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Check for swelling. No matter how hard it is hit, your finger will swell. This is the most common response to such trauma. The finger will only swell for a few days if the force is not too strong. If your only symptom is swelling, you can apply an ice pack to your finger to help reduce swelling and pain.

You can also take over-the-counter pain relievers.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) can also reduce pain and inflammation. Take as directed on the medicine box. ^{[1] X Research Source}
You don’t need to see a doctor unless your finger doesn’t swell, the wound is painful or numb, or the finger can’t move in or out. ^{[2] X Research Sources}^{[3] X Research Sources}

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Treatment of fractures. If your finger is very swollen and painful, you may have broken a finger bone, especially if the blow was quite strong. If your finger looks crooked and is extremely sensitive to the touch, it’s likely broken. This condition may be accompanied by bleeding in the skin or a broken nail.

Seek medical attention if a fracture is suspected. You need an X-ray, and your doctor may splint your finger or have another form of treatment. Do not splint your finger unless directed by your doctor. ^{[4] X Research Sources}

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Wash the wound. If your finger bleeds after being hit, you need to clean the wound to assess the extent of the damage. Wash your fingers under warm running water if you notice bleeding. Place your finger under the faucet so that the water drains down the drain, not back into the wound. Then use gauze to wash the wound with betadine or another solution.

Apply pressure to the wound for a few minutes to slow the bleeding, so you can assess how deep the wound is and if a doctor is needed.
Call 911 immediately if bleeding is excessive or streaks. ^{[5] X Research Sources}

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Evaluation of the tear. Once you’ve cleaned the wound, you’ll need to check your finger for cuts or cuts. The wound may still bleed a little while you are being examined, this is normal. The lacerations usually take the form of a rip or a piece of skin on the finger. Any significant tissue damage or skin rips to reveal bleeding flesh should be examined by a physician. Sutures may be needed if the tear is 1.2 cm or more wide. However, the layer of skin may not be able to hold if part of it is completely destroyed.

Many doctors still stitch the damaged skin over the flesh of the finger to form a protective layer while the young skin is growing. The outer layer of skin is cut away when new skin has formed.
The lacerations can be shallow and stop bleeding soon after the tear, especially if the finger is not hit too hard. If this is the case, wash the wound, apply antibiotic ointment, and cover it with a bandage. ^{[6] X Research Sources}

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Check for tendon damage. The hand and finger are a complex system of muscles, tendons, and nerves, so it’s important to examine your fingers for signs of tendon damage. Tendon is the part that connects muscle to bone. The hand has two types of tendons: the flexor tendon in the palm of the hand, which helps to flex the fingers; and the extensor tendon on the back of the hand helps to straighten the finger. Cuts and bruises can damage or even break these tendons. ^{[7] X Research Sources}

You cannot bend your finger if the tendon is torn or broken.
Cuts in the palm or near the crease at the knuckles can damage the tendons underneath.
You may also feel numbness due to nerve damage.
Soft palms can be a sign of damaged tendons.
You may need to resort to the intervention of a surgeon if any of these signs are present, as hand and finger treatment is a complex process.

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Consider nails. Nails can be severely damaged if hit with a hammer. Observe the nail and assess for damage. You don’t need to see a doctor if you only see a small spot of blood underneath your nail. Just cover the wound with ice and take over-the-counter medication if it hurts. However, you should seek medical attention if the pain persists for several days, the blood stain covers 25% of the nail, or if the blood puts great pressure underneath the nail. It is likely that you have had a hematoma under the nail.

You may find that part of your nail is detached or broken. If the nail bed is deeply broken, you need medical attention as the wound may need stitches. If left untreated, a cut can interfere with nail growth, cause the nail to grow out of place, or cause an infection.
Seek medical attention right away if part or all of a nail is lost. This is a serious condition and needs attention. Damaged nails can be removed or sutured until a new, healthy nail grows back. This process can take 6 months. ^{[8] X Research Sources}^{[9] X Research Sources}

Treating hematoma under the nail

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Go to the doctor. You need to see a doctor if there is a lot of hematoma under the nail, which is more than 25% of the nail area. A subungual hematoma means an area of small broken blood vessels under the nail. Your doctor may suggest that you extract or make an incision in your nail to drain the blood. You can do this yourself if it’s quick. If the pain is severe, push the skin of the cuff deep inside to gently insert the sterile needle. This won’t hurt as much as your injured finger, and it’s easier for the needle to get into the base of the nail. Withdraw several times until clear fluid drains out. This helps prevent the nails from turning black due to the dried blood under the nail.

You do not need to do anything if the blood stain under the nail covers less than 25% of the nail area. The blood stain will move upward on its own as the nail grows longer. The degree to which the nail turns black as the blood dries depends on how hard or lightly the nail is beaten. ^{[10] X Research Source}
If the hematoma covers more than 50% of the nail, the doctor will order an X-ray of the nail.
You should see a doctor to treat a hematoma under the nail within 24-48 hours.

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Draw blood in the clinic. The safest way to draw blood under the nail is to have the doctor do it by burning. During this procedure, your doctor uses an electrocautery device to make a small hole through the nail. When the cauterization reaches the hematoma under the nail, the tip will automatically cool down to ensure that the finger is not burned.

After the hole is punched, blood will seep out of the nail until the pressure drops. Your doctor will bandage your finger and send you home.
Your doctor may use an 18-gauge needle instead, but cauterization is still more commonly used.
This procedure is painless, because the nail has no nerves. ^{[11] X Research Source}
This method helps reduce pressure that builds up under the nail, which means you’re less likely to have to remove the nail.

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Treatment of hematoma under the nail at home. Your doctor may allow you to drain a subungual hematoma at home. Prepare a paper clip, a lighter and wash your hands thoroughly to perform this trick. Straighten the paper clip and turn the lighter over the top of the paper clip for 10-15 seconds until it is red hot. Then place the tip of the paper clip in the center of the hematoma at a 90 degree angle to the nail bed. Gently press down, slowly twisting in place so that the paper clip penetrates the nail. At that time, blood will flow out of the nail. Use a cloth or gauze to wipe the bleeding.

If it doesn’t go through the nail the first time, you need to reheat the tip of the paper clip and try again, pressing down a little harder so that the tip of the paper clip penetrates the nail.
Do not press too hard, as you may hit the nail bed.
You can take a pain reliever before the procedure if your finger hurts a lot.
Ask a close friend or family member to help you if you are unable to do this yourself. ^{[12] X Research Source}

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Wash your nails again. Once the bleeding has stopped, you need to rinse the nail again with betadine or another cleaning solution. Bandage your finger with a gauze bandage, which wraps in a cotton ball over the tip of the finger to form a soft cushion while also protecting the finger from irritation and impact. Secure at the base of the finger with medical tape. ^{[13] X Research Source}

You can also tape in a figure eight pattern, from the finger to the base of the hand. This will keep the tape in place.

Continue to take care of your fingers

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Dressing changes. No matter how damaged your finger is, you should change the bandage once a day. However, you need to change it sooner if you find that the bandage is dirty before 24 hours. When removing the bandage, the finger should be washed with an antiseptic solution and re-bandage in the same way as before.

If your finger requires stitches, you should ask your doctor before washing. Take care of your stitches according to your doctor’s instructions. You may need to keep it dry and not wash it with any solution. ^{[14] X Research Source}

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Observe for signs of infection if present. Each time you remove the bandage, look for signs of infection on the wound. Look for pus, discharge, redness, or heat, especially when those signs come from the hand or arm. You should also be aware if you start to have a fever, as complications can develop, including infections such as cellulitis, periungual pyelonephritis, or other hand infections. ^{[ 15] X Research Source Clark, Dwayne, CDR MC USN, Common Hand Infections, American family Physician 2003 Dec 1, 68(11), 2167-2176}

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Continue to see the doctor again. A few weeks after your injury, you should see your doctor again. Your doctor will schedule a follow-up appointment if you have sutured or extracted a hematoma under your nail. However, you should always see a doctor when experiencing such severe injuries.

Be sure to contact your doctor if other symptoms arise, an infection is suspected, dirt gets into the wound and can’t be removed, the pain worsens, or the wound starts to bleed uncontrollably. ^{[16] X Research Source}
You should also contact your doctor if you have symptoms of nerve damage, including: loss of sensation, numbness, or the formation of a scar called a “neuroma,” which often causes pain and feels like electric shock when touched. ^{[17] X Research Source}

Steps

Finger care

Treating hematoma under the nail

Continue to take care of your fingers

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