A simple painless technique to drain subungual hematoma

Subungual hematoma drainage is indicated whenever the hematoma causes pain or concerns more than 50% of the nail (or more than 25% with an associated fracture).1 Studies have shown that trephination has the same efficacy as complete removal of the nail. If the subungual hematoma is associated with the complete avulsion of the nail, a displaced phalanx fracture or a proximal fracture involving the germinal matrix, complete removal of the nail with nail bed repair, and repositioning of the perforated nail are required.