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Finger Injury

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Definition

  • Injuries to fingers

Types of Finger Injuries

  • Cuts, Scrapes (skinned knuckles) and Bruises. These are the most common injuries.
  • Jammed Finger. The end of a straightened finger or thumb receives a blow. Most often, this is from a ball. The energy is absorbed by the joint surface and the injury occurs there. This is called traumatic arthritis. For jammed fingers, always check that the fingertip can be fully straightened.
  • Crushed or Smashed Fingertip. Most often, this is from a car door or a screen door. The end of the finger may get a few cuts or a blood blister. Sometimes, the nail can be damaged. Broken bones are not common with this kind of injury. If they do occur, they are at risk for a bone infection (osteomyelitis).
  • Fingernail Injury. If the nailbed is cut, it needs sutures to prevent a deformed fingernail.
  • Subungual Hematoma (Blood Clot under the Nail). Most often caused by a crush injury. This can be from a door crushing the finger. It can also be from a heavy object falling on the nailbed. Many are only mildly painful. Some are severely painful and throbbing. These need the pressure under the nail released. A doctor can put a small hole through the nail. This can relieve the pain and prevent loss of the fingernail.
  • Dislocations. The finger has been pushed out of its joint.
  • Fractures. Finger has a broken bone.

Pain Scale

  • Mild: your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
  • Moderate: the pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
  • Severe: the pain is very bad. It keeps your child from doing all normal activities.
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When To Call

Go to ER Now

  • Bleeding that won't stop after 10 minutes of direct pressure
  • Looks like a broken bone or dislocated joint

Call Doctor or Seek Care Now

  • Skin is split open or gaping and may need stitches
  • Large swelling is present
  • Blood under a nail is causing more than mild pain
  • Fingernail is torn off
  • Base of nail has popped out from under the skin fold
  • Cut over knuckle of hand
  • Dirt in the wound is not gone after 15 minutes of scrubbing
  • Can't open and close the hand or use the fingers normally
  • Severe pain and not better 2 hours after taking pain medicine
  • Age less than 1 year old
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Dirty cut and no tetanus shot in more than 5 years
  • Clean cut and no tetanus shot in more than 10 years
  • Pain not better after 3 days
  • Not using the finger normally after 2 weeks
  • You have other questions or concerns

Self Care at Home

  • Minor finger injury
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Care Advice

  1. What You Should Know About Finger Injuries:
    • There are many ways that children can hurt their fingers.
    • There are also many types of finger injuries.
    • You can treat minor finger injuries at home.
    • Here is some care advice that should help.
  2. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  3. Bruised/Swollen Finger:
    • Soak in cold water for 20 minutes.
    • Repeat as needed.
  4. Small Cuts or Scratches:
    • For any bleeding, put direct pressure on the wound. Use a gauze pad or clean cloth. Press down firmly on the place that is bleeding for 10 minutes. This is the best way to stop bleeding. Keep using pressure until the bleeding stops.
    • Wash the wound with soap and water for 5 minutes.
    • For any dirt in the wound, scrub gently.
    • For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
    • Cover it with a bandage (such as Band-Aid). Change daily.
  5. Jammed Finger:
    • Caution: Be certain range of motion is normal. Your child should be able to bend and straighten each finger. If movement is limited, your doctor must check for a broken bone.
    • Soak the hand in cold water for 20 minutes.
    • If the pain is more than mild, "buddy-tape" it to the next finger.
  6. Smashed or Crushed Fingertip:
    • Wash the finger with soap and water for 5 minutes.
    • For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
    • Cover it with a bandage (such as Band-Aid).
  7. Torn Nail (from catching it on something):
    • For a cracked nail without rough edges, leave it alone.
    • For a large flap of nail that's almost torn through, cut it off. Use a pair of scissors that have been cleaned. Cut along the line of the tear. Reason: Pieces of nail taped in place will catch on objects.
    • Soak the finger for 20 minutes in cold water for pain relief.
    • Use an antibiotic ointment (such as Polysporin). No prescription is needed. Then cover with a bandage (such as Band-Aid). Change daily.
    • After about 7 days, the nailbed should be covered by new skin. It should no longer hurt. A new nail will grow in over 6 to 8 weeks.
  8. Call Your Doctor If:
    • Pain becomes severe
    • Pain not better after 3 days
    • Finger not normal after 2 weeks
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.
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