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March 1, 2006 10:16 AM   Subscribe

I slammed my thumb in my car door this morning, and it hurts. A lot. What can I do to keep my nail from falling off?

There is only a small spot that looks really bruised under the nail, but the whole nail bed is tight and hot compared to my other fingernails. Putting pressure on my thumbpad makes that feeling worse. I ran cold water over it, put ice on it, and held pressure on it the whole drive to work (about 30 minutes), but I'm really not digging the idea of my thumbnail falling off. I searched the other threads, those people seemed to have considerably more trauma to their hands than I do. Any advice?
posted by Medieval Maven to Health & Fitness (17 answers total)
I think continuing to ice it to keep the swelling down is your best bet.
posted by Good Brain at 10:23 AM on March 1, 2006

Go to the ED. If the bruised spot is blood under the nail, they can put a hole in the nail to relieve pressure. I know someone who did this himself with a hot needle, but I'm not suggesting it.
posted by Saccade at 10:27 AM on March 1, 2006

Well, a few years ago I managed to drop a jar of peanut butter on my big toe with much the same results. I wound up going to see my doctor the next day, who basically just drilled a small hole in the nail to relieve the swelling. She said I could've done the same thing with a heated safety pin. I can't say I'd feel entirely comfortable doing that myself, but it did work: a whole bunch of fluid under the nail drained out in a grossly satisfying way, which took care of the pain. Part of my nail did eventually fall off, but it was much more gradual. It's since grown in just fine.

On preview, Saccade and I share some kind of freaky mind-meld.
posted by Vervain at 10:28 AM on March 1, 2006

Having just done this myself, recently I have to say that I don't think there is anything you can do to keep the nail in place. Either it will come off or it won't.

The advice my doc gave me when I did this:
-- Ice
-- Keep it elevated (keep the hand/thumb above your heart)
-- Tylenol the 1st 24 hours for the pain

I was "lucky" and actually burst the nail in the middle so it didn't need to be drained, but you want to watch out for a large build-up of fluids under the nail -- it will feel like a huge amount of pressure under the nail, like the nail wants to just pop off but can't. My understanding is that this might take a few days and will really, really hurt if youi get to the point where the nail needs to be piereced so the fluid can drain.

I was also told that most nails do not actually fall off from this sort of trauma; mine did, due to the build up of dried blood under the nail, but also bear in mind that I slammed mine on September 27th, the nail fell off November 28th, and just this week the nail reached the normal place where the end of the nail should be. Its a long process. Trust me that the pain goes away in about 48-72 hours. Then you just have to wait.....
posted by anastasiav at 10:43 AM on March 1, 2006

Melt a hole in your nail with a heated, straightened paper clip. Proceed slowly, and the instant you got through the nail, the blood will rush out and cool the paper clip. It doesn't hurt a bit - honestly and truly. Your nail has no nerves, and you never actually touch anything under the nail.

(The burning smell may be a bit weird - like burning hair.)
posted by mediaddict at 10:58 AM on March 1, 2006

medaiddict's thing works great if there is bleeding trapped underneath the nail, building up pressure and causing lots of pain -- I've done it myself, and it works like a charm. Try to put the hole as far towards the tip of the nail (while still being inside the bloody area) as possible, so it'll grow out faster.

But I would only recommend doing it if the pain is sufficient to get you over the squick of burning holes in yourself with a paper clip.

It takes a lot of trauma to cause a nail to fall completely off. I once bent one of my toenails straight back, practically ripping it off the toe, but after folding it back in place (and screaming a lot) it grew right back in.
posted by ook at 11:35 AM on March 1, 2006

Saccade writes "Go to the ED. If the bruised spot is blood under the nail, they can put a hole in the nail to relieve pressure. "

Drill a hole in the nail in order to a) relieve some of the pressure causing pain and b) stand a greater chance of keeping the nail. My wife the RMT and Certified AT has a special hand drill to do this but an ordinary model maker's pin vice will do the job for about $3. Sterilize with an alcohol wipe. I like the drill rather than buring thru because you can control the depth easier IMO.
posted by Mitheral at 11:36 AM on March 1, 2006

I swear, all Vervain and Saccade need to make me think they're spamming trolls is a URL to some product that promises to help your nails. Those posts are creepily similar! (Mind melds are scary things. I know you're not the same.)

Um... I'd make sure I have the stomach for piercing my toenail and causing a pool of blood to form up before going all Oedipus-eyes on it.

Just sayin'.
posted by disillusioned at 11:58 AM on March 1, 2006

From my experience with my big toe nails falling off after slamming them, there are two issues here: one is the bruising and blood under the nail and the other is whether or not the nail has detached from the nail bed. Even if you relieve the pressure from the blood under the nail and the nail stays on in the short-term, it still may get pushed off from the new nail growing out underneath it. That's what has happened to me twice, It looked like the nail was OK but within a few weeks you could see a new nail growing underneath it. Eventually the old nail got pushed up far enough that I could "pop" it off.

Incidentally, this thread is really grossing me out.
posted by octothorpe at 12:00 PM on March 1, 2006

FWIW, I tried drilling, and failed; it felt like it was twisting the nail around, which hurt. (Besides, not everybody has a pin vice lying around.) The paperclip worked much more easily and painlessly, though it did take a couple of too-shallow attempts before I could judge how long I needed to leave it on there. (Don't push, just rest the hot tip on the nail gently for a moment; it'll sizzle a bit and, yes, smell exactly like burning hair.)

None of this may actually be appropriate for Maven, though, who sounds just bruised: if there isn't a visible bubble of blood under the nail that needs to be let out, then ice and painkillers are probably a better bet. And lots of screaming, I find that helps.
posted by ook at 12:00 PM on March 1, 2006

When the ER burned a hole in my fingernail it hurt like a motherfucker. They probably went too deep and into the tissue under the nail. Done correctly it shouldn't hurt.
posted by DieHipsterDie at 12:20 PM on March 1, 2006

Jinx, Vervain!!
posted by Saccade at 12:29 PM on March 1, 2006

FWIW this is a Subungal Haematoma.

Really, the shit my brain retains...
posted by hardcode at 12:49 PM on March 1, 2006

I suggest to NOT go through the nail. The bf had a bookcase fall on his toe hast year (ouch) and had to go to a podiatrist. What he did was cut through the skin just below the cuticle, let the blood out, then disinfect and bandaged.

The problem with cutting through a nail is that it doesn't heal, and so would continue to puss through the bandage. If you cut through the skin to let the blood/puss out (you might have to do it a few times) the blood can close off the wound.

The nail DID come off eventually (come on, it's a BOOKCASE!) but it stayed on until the new one grew in. In the worst case scenario...we kept filing it until it grew in smoothly.
posted by Sallysings at 12:53 PM on March 1, 2006

I played rough when I was little, so I have both lost a lot of nails and put holes though a couple of them.

Like others said, it is easy and painless if done right, I used a sewing needle which I did not heat, rather spun it so it drilled though the nail. Never hurt.

It also seems to matter whether it is a straight on trauma or the tramua came from the side of the nail bed which seems to cause more nails falling off.
posted by stormygrey at 1:22 PM on March 1, 2006

It looked like the nail was OK but within a few weeks you could see a new nail growing underneath it. Eventually the old nail got pushed up far enough that I could "pop" it off.

Yeah, that's pretty much what happened with my toe. It, too, was satisfying in a really squicky sort of way. But I am not enough of a badass to refrain from wigging the fuck out at the prospect of neatly folding my nearly-detached nail back into its bed.

(I only wish I had some miracle nail cure to pimp, 'cause then I might be further along the road that ends with me swimming Scrooge McDuck-style in a big old vat of money. As it is, I can only say that the bottle of tea tree oil I (apparently) sent my mother has cleared up her toenail fungus.)
posted by Vervain at 2:42 PM on March 1, 2006

Umpteenth the hot paper clip. It makes a slightly larger hole, and you have to keep it open or the pain returns. You can use a dab of peroxide to keep old blood from pooling over the hole. (Only if you have blood under the nail causing pressure, and you'll know if it is.)

I don't know about fingernails, but I split a big toenail almost to the quick, and it healed fine, then got toenail fungus going in it. Tea tree oil, huh? 'Cause the Magic Anti-fungal Toenail Polish costs a fortune, and isn't covered by insurance.
posted by unrepentanthippie at 4:44 AM on March 2, 2006

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