Considerations

If an injury to a finger occurs at the tip and does not involve the joint or nail bed, you may not need the help of a doctor. If the tip of your finger bone is broken, your doctor may not recommend a splint.

If the injury is more towards the palm or involved the joint, be sure to seek medical help right away.

Causes

Finger(s) can be smashed by a hammer blow, a car door, a desk drawer, a baseball, or some other force.

Symptoms

• Difficulty moving the tip of your finger
• Discoloration or bruising of the finger or fingernail
• Finger pain
• Loss of fingernail
• Swelling

First Aid

Apply an ice pack to decrease the swelling. Over-the-counter pain medications may help relieve discomfort.

If pain becomes excessive, with blood under the fingernail, talk to your health care provider. Your health care provider may assist you in taking the following steps to relieve the pressure and prevent the fingernail from falling off.

1. Heat the end of a bent paper clip (or a similar size metal wire) over an open flame until it is red hot. Use a pair of pliers to hold the paper clip during sterilization.
2. While it is still very hot, touch the tip of it to the injured fingernail. This is not a painful procedure for most people.
3. The heat of the clip will burn a small hole in the fingernail. It is not necessary to press hard on the fingernail to burn a hole.
4. As the paper clip is removed, blood should start releasing through the small hole. If not, retry the procedure until blood comes out and pressure is relieved.
5. The pain will be relieved as the pressure is released. Keep the finger dry for 2 days.
6. This procedure can be repeated, if necessary, if the hole closes over and the pressure rebuilds.
7. Wash the finger carefully before and after the procedure. Seek medical help if the crush area is very dirty, if the procedure doesn’t work, or if the finger looks like it might be infected. You may need antibiotics.

DO NOT

• DO NOT Splint a smashed finger without first consulting your health care provider. You may decrease finger movement.
• DO NOT Try to drain a swollen finger unless your health care provider instructs you to do so.

When to Contact a Medical Professional

Call for immediate medical attention if the finger is deformed, or if the injury is not limited to the tip of the finger.

Prevention

Teach safety to young children, and use caution when shutting doors to make sure fingers are not in danger.

Alternative Names

Finger(s) - smashed; Crushed digits

References

Lyn ET, Mailhot T. Hand. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 47.

Butler KH. Incision and drainage. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 37.

Update Date: 4/4/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.