Finger or Toe Injury
What is a finger or toe injury?
Common injuries include bruises, cuts, torn nails, or jammed
fingers. Bruising and swelling is usually caused from the soft
tissues and underlying bones being smashed or hit.
In crush injuries (as from slammed car doors), usually the end of
the finger or toe receives a few cuts. Occasionally the nail is
damaged and the nailbed requires stitches. Rarely is there any
fracture of the small underlying bone.
A jammed finger occurs if the end of a straightened finger or
thumb receives a blow (usually from a ball). The energy is
absorbed by the joint surfaces and the injury occurs at the joint.
If a finger is jammed, always check carefully that your child can
bend and then fully straighten his or her finger.
How can I take care of my child?
- Bruised finger or toe
Soak it in cold water for 20 minutes. Give your child
acetaminophen or ibuprofen as necessary for the pain. Call
your child's healthcare provider if the pain is not improving
by 3 days.
- Jammed finger
Soak the hand in cold water for 20 minutes. Give acetaminophen
or ibuprofen as necessary for the pain. (Avoid aspirin because
it may prolong the bleeding.) It's going to be sensitive for
the next week, so protect it by "buddy-taping" it to the next
finger. A splint could be used but often makes it more prone
to getting bumped. Call your child's healthcare provider if
the pain is not improving within 3 days.
- Smashed or crushed fingertip
Before taking care of this yourself, check the guidelines on
when to call your child's healthcare provider below.
Soak the hand in cold water for 20 minutes. Give your child
acetaminophen or ibuprofen as necessary for the pain. (Avoid
aspirin because it may prolong the bleeding.) Call your
child's healthcare provider if any signs of infection develop
or the pain hasn't improved in 3 days.
- Torn nail
These recommendations apply to a nail that has been torn by
catching on something. If the nail was torn by a crush injury,
your child needs to see a doctor. If the nail is cracked but
there are no rough edges, leave it alone.
If the nail is almost torn through or there is a large flap of
nail, use sterile scissors or nail clippers to cut along the
line of the tear. Pieces of nail taped in place will catch on
objects. Soak the finger for 20 minutes in cold water. Apply
an antibiotic ointment (such as bacitracin or Betadine) and
cover it with a Band-Aid. Each day, remove the dressing and
soak the finger in a warm salt solution (1/2 teaspoon of salt
to a pint of water).
By the seventh day, the nailbed should be covered with new
skin, and both the soaking and the bandaging can be stopped. A
new nail will grow in over the next 1 to 2 months. Call your
child's healthcare provider if you see any signs of infection.
- Cuts
Wash the wound vigorously with soap and water for 5 minutes.
Then apply pressure for 10 minutes with a sterile gauze to
stop bleeding. Leave the area exposed to the air.
- Skinned knuckles
These wounds are deep scrapes of the upper surfaces of fingers
or toes. Wash the wound vigorously for 5 minutes with water
and liquid soap. Scrubbing with a sterile gauze may be
necessary to get all the dirt out. Flaps of skin (especially
if they are dirty) should be cut off with sterile scissors.
When the wound is clean, apply pressure for 10 minutes with a
sterile gauze to stop any bleeding. Apply an antibiotic
ointment and cover with a Band-Aid. Remove the dressing and
clean the wound each day. Call your child's healthcare
provider if you see any signs of infection.
- Ring caught on swollen finger
In most cases, the ring can be saved rather than cut off. The
key to removing the ring is reducing the swelling of the
finger. Soak the hand in cold water for 5 minutes. Then hold
it (with all the fingers straightened) high in the air. Then
put a glass cleaner or cooking oil on the finger. While the
hand is still held up in the air, push the ring with steady
upward pressure until it slides off. If it won't slide off,
call your child's healthcare provider immediately before the
swelling gets worse.
When should I call my child's healthcare provider?
Call IMMEDIATELY if:
- The skin is split open and may need stitches.
- Blood collects under a nail AND becomes very painful.
- There is any dirt or grime in the wound you can't get out.
- A crush injury has damaged the skin or fingernail.
- A finger can't be opened (straightened) and closed (bent)
completely.
Call during office hours if:
- The injury looks infected.
- Your child is not using the finger or toe normally after 1
week.
- You think your child may need a tetanus shot.
- You have other questions or concerns.
Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
Published by
RelayHealth.
Last modified: 2007-03-23
Last reviewed: 2008-06-09
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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