Definition
- Injuries to fingers or toes
Types of Finger / Toe Injuries
- Cuts, scrapes (skinned knuckles) and bruises: the most common injuries
- Jammed finger or toe: The end of a straightened finger or thumb receives a blow (usually from a ball). The energy is absorbed by the joints’ surfaces and the injury occurs there. For jammed fingers, always check carefully that the end of the finger can be fully straightened.
- Crushed or smashed fingertip or toe (e.g., from car door or screen door): Usually the end of the finger receives a few cuts or a blood blister. Occasionally the nail is damaged, but fractures are unusual.
- Fingernail injury: If the nailbed is cut, it needs sutures to prevent a permanently deformed fingernail. This is less important for toenails.
- Blood clot under the nail: Usually caused by a crush injury from a door or a heavy object falling on the finger while it is on a firm surface. Many are only mildly painful. Some are severely painful and throbbing. These need the pressure released to prevent loss of the fingernail and to relieve the pain.
- Fractures or dislocations
When to Call Your Doctor for Finger or Toe Injury
Call Your Doctor Now (night or day) If
- You think your child has a serious injury
- Bleeding won’t stop after 10 minutes of direct pressure
- Looks like a broken bone or dislocated joint
- Skin is split open or gaping and may need stitches
- Large swelling is present
- Blood that’s present under a nail
- Fingernail is torn
- Dirt or grime in wound is not removed after 15 minutes of scrubbing
- Finger joint can’t be opened (straightened) and closed (bent) completely
- Toe injury that causes bad limp or can’t wear shoes
- Pain is SEVERE (and not improved after 2 hours of pain medicine)
- Age under 1 year old
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- No tetanus shot in over 5 years for DIRTY cuts (over 10 years for CLEAN cuts)
- Pain not improving after 3 days
- Not using the finger or toe normally after 1 week
Parent Care at Home If
- Minor finger or toe injury and you don’t think your child needs to be seen
Home Care Advice for Minor Finger/Toe Injuries
- Bruised/Swollen Finger or Toe:
- Soak in cold water for 20 minutes.
- Give acetaminophen (e.g., Tylenol) or ibuprofen as necessary for pain relief.
- Superficial Cuts:
- Apply direct pressure for 10 minutes with a sterile gauze to stop any bleeding.
- Wash the wound with soap and water for 5 minutes.
- For any dirt in the wound, scrub gently.
- Cover any cuts with an antibiotic ointment such as Polysporin (no prescription needed). Then apply a Band-Aid. Change daily.
- Jammed Finger or Toe:
- Caution: be certain range of motion is normal (can bend and straighten each finger). If movement is limited, must check for a fracture.
- Soak the hand or foot in cold water for 20 minutes.
- Give acetaminophen (e.g., Tylenol) or ibuprofen as necessary for pain relief.
- If the pain is more than mild, protect it by “buddy-taping” it to the next finger.
- Smashed or Crushed Fingertip or Toe:
- Wash the finger (or toe) with soap and water for 5 minutes.
- Trim any small pieces of torn skin with a fine scissors cleaned with rubbing alcohol.
- Cover any cuts with an antibiotic ointment such as Polysporin (no prescription needed). Then apply a Band-Aid. Change daily.
- Give acetaminophen (e.g., Tylenol) or ibuprofen as necessary for pain relief.
- 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, use a sterile scissors to cut it off along the line of the tear (Reason: Pieces of nail taped in place will catch on objects).
- Soak the finger or toe for 20 minutes in cold water for pain relief.
- Apply an antibiotic ointment such as Polysporin (no prescription needed). Then cover with a Band-Aid. Change daily.
- After about 7 days, the nailbed should be covered by new skin and no longer hurt. A new nail will grow in over 6 to 8 weeks.
- Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as needed for pain relief.
- Shoes: If regular shoes cause too much pain, wear open-toe sandals with a firm sole until the injury heals.
- Call Your Doctor If:
- Pain becomes severe
- Pain not improving after 3 days
- Not using the finger or toe normally after 1 week
- Your child becomes worse
And remember, contact your doctor if your child develops any of the “When to Call Your Doctor” symptoms.
References
- Ablove RH, Moy OJ, Peimer CA. Pediatric hand disease: Diagnosis and treatment. Pediatr Clin North Am. 1998; 45:1507-1524.
- Benjamin HJ, Mjannes JM, Hang BT. Getting a grasp on hand injuries in young athletes. Contemp Pedatr. 2008;25(3): 49-63.
- Feter-Zarzeka A, Joseph MM. Hand and fingertip injuries in children. Pediatr Emerg Care. 2002;18:341.
- Wang M, Schott J, Tunnessen WW: Hair-thread tourniquet syndrome. Arch Pediatr Adolesc Med. 2001;155:515-516.
Disclaimer
This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 8/1/2010
Last Revised: 9/15/2010 11:36:29 AM
Copyright 1994-2011 Barton D. Schmitt, M.D.