How to Treat a Smashed Finger

A smashed finger is an injury involving trauma to one or more fingers. In most cases, a smashed finger won't require medical treatment but can instead be treated at home with first aid, ice, and over-the-counter (OTC) pain relievers.

However, there may be times when a smashed finger is severe (such as a broken finger) and requires immediate medical care. Knowing when to act can help you avoid complications.

This article walks you through the first aid steps if you or someone you know has a smashed finger. It also describes what not to do if you injure your finger and when to see a healthcare provider.

Immediate First Aid for a Smashed Finger

The first step in treating a smashed finger is to manage the pain and swelling. There are four ways to do this:

• Ice application: An ice pack can quickly reduce pain and swelling. Apply ice for 15 minutes at a time, a couple of times an hour for the first few hours. Don't ice the finger for more than 15 minutes and wrap the ice pack in a clean cloth first to prevent cold injury to the skin.
• Elevation: Raising the injured finger above the heart slows the blood flow and reduces the throbbing. Letting your hand dangle will increase the pain and swelling.
  
• Take a pain reliever: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) can help reduce pain and swelling. Tylenol (acetaminophen) is also good for relieving pain.
• Move your finger: If possible, keep using the finger to promote circulation. If you can't move it or begin to lose sensation in the finger, call your healthcare provider.

What Not to Do

There are two things you should not do if you have a smashed finger:

• Do not wrap a smashed finger: Compression is sometimes used for joint injuries like a wrist strain or knee sprain, but not for a smashed finger. Doing so can reduce the blood flow which reduces the oxygen and nutrients the finger needs to heal.
• Do not splint a smashed finger: Splinting may be useful if there's a break but it can also affect blood circulation. Don't splint your finger without first speaking with your healthcare provider.
  

Treating Blood Under a Fingernail

When a finger is smashed, blood can pool beneath the fingernail, leading to what is called a subungual hematoma. After a day or two, the nail may start to turn purple, blue, or even black.

Your healthcare provider may consider draining the blood if it is causing pain but will otherwise leave it alone. In more cases than not, the nail will look worse than it actually is and will benefit from being left alone.

Healthcare providers generally advise against draining the nail yourself as you can injure yourself or cause an infection by introducing bacteria into the nail bed.

If the pressure beneath the nail is causing severe pain, your healthcare provider may give you the OK to drain the blood yourself. Doing so requires four pieces of equipment: a lighter, a pair of pliers, a clean paper clip, and a clean paper towel.

To drain blood from your finger:

1. Wash the finger thoroughly with soap and water.
2. Open the paper clip so that you have a straight edge.
3. Holding the paper clip with the pliers, heat the tip in the flame until it is red hot.
4. Carefully touch the red-hot tip to the part of the nail where the most blood has collected.
5. Place gentle pressure and allow the heat of the paper clip to burn through the nail plate. Do not push.
6. As the paper clip penetrates the nail, there may be a gush of blood. Remove the paper clip and use the paper towel to wipe away any excess blood.

This can be repeated as needed but should only be done if there is pain. This should not be done for cosmetic reasons.

If your nail eventually falls off, don't panic. It may not be ideal, but chances are good that the nail will grow back.

When to Seek Medical Treatment

In most cases, a smashed finger won't require medical treatment. Depending on the extent of the injury, the pain may last for a few days or weeks. With that said, it may be necessary to seek care if the injury is severe, the pain and swelling don't subside, or there are obvious signs of a fracture.

Knowing when to act can sometimes be difficult. A broken finger, for example, is often hard to differentiate from a sprained (jammed) finger. The difference lies mainly in the severity and duration of symptoms.

With a sprained finger, there may be pain, swelling, and difficulty moving the finger, but these usually improve within a few days. With a broken finger, the signs and symptoms are invariably more severe and longer lasting.

Common signs and symptoms of a broken finger include:

• Extremely sharp pain at the injured site
• Swelling and tenderness that lasts for several days
• Swelling that extends to other parts of the hand
• Severe bruising around the injured site
• Inability to move the finger without extreme pain or at all
• A misshapen or deformed finger
• Numbness, burning, or tingling sensations

At the time of injury, it is also common to hear a crack as the finger breaks. The piercing of the skin with a bone fragment is another very obvious sign of a fractured finger.

Summary

If you smash a finger, the first step is to relieve the swelling and pain with an ice pack, elevation, and an OTC pain medication if needed. Moving the finger helps promote circulation. If there is blood beneath the fingernail, do not drain it yourself unless your healthcare provider recommends it.

Unless your healthcare provider says otherwise, never splint or wrap a smashed finger as this can impede blood flow. While most smashed fingers don't require medical treatment, you should seek treatment if there are signs of a fracture, the injury looks severe, or the pain and swelling persist.