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Smashed Finger

A finger or toe smashed in a car door or jammed against a hard object is a common injury, especially among children. Young children should be seen by a health care provider for evaluation. For adults and older children, when  these injuries involve only the end segment of the finger or toe, and not a deep or bad cut, they often can be treated successfully at home.

First Aid

Minor fractures of the bone in the tip of the finger or toe are often left untreated. However, some fractures need to be splinted.

Blood often pools under the nail of the smashed finger or toe, causing severe throbbing pain. A doctor can relieve this pressure by draining the blue-black blood you can see through the nail. If the blood is under more than a third of the nail, see your doctor.

Often the nail is partly pulled off during the accident. Do not pull it off. See your doctor, who may be able to fix it.

There are several steps you can take to relieve pain and speed healing of a smashed finger or toe or torn nail.

After 2-3days of self care if the symptoms haven’t improved, call your health care provider.

For Smashed Fingers:

  • If the person can move the smashed finger or toe easily and the injury does not involve the nailbed, apply an ice pack to reduce swelling and use acetaminophen or a similar over-the-counter pain reliever.

  • If the finger or toe is bleeding, apply pressure on the wound and elevate above the heart until bleeding stops. Wash the wound with soap and water, and watch for any signs of infection.

  • If you suspect a possible bone fracture or the smashed finger or toe involves a deep or serious cut, seek medical attention immediately.

For Torn Nails:

  • Clip carefully along the line of tear.

  • Soak nail for 20 minutes in cold water to reduce swelling.

  • Apply antibiotic ointment and cover with nonstick sterile dressing to keep clean.

  • On second and third days, cover loosely with an adhesive bandage, use antibiotic ointment, and continue to soak.

  • On fourth through sixth day, soak daily in warm salt water (1/4 teaspoon in 8 ounces of water) and apply antibiotic ointment. Cover with nonstick sterile dressing to keep clean.

  • On seventh day, stop the soaking and dressing; new skin should be formed.

Decision Guide for Smashed Fingers and Ttoes

Symptoms/Signs

Action

Minor discomfort (slight redness, swelling, pain; may have red/brown linear marks)

 Use self-care

Torn nail

 Use self-care

End of nail appears to droop

 See provider

Significant pain and swelling

 See provider

Visible deformity

 See provider

Severe pain and visible blood under nail if blood is under 1/3 of nail

 See provider

Deep cuts or scratches that may need stitches (edges separate or gape more than 1/2 inch in length)

 See provider

Tetanus booster needed

 See provider

Crushing or wringer type injury, unable to straighten finger or toe

 Seek help now

Nail completely torn off (bring nail to doctor)

 Seek help now

Numbness or tingling in finger or toe, cool to touch

 Seek help now

Publication Source: Well Advised, Second Edition, Text copyright © 2003 Park Nicollet Institute
Online Editor: Sinovic, Dianna
Online Medical Reviewer: Godsey, Cynthia M.S., M.S.N., APRN
Online Medical Reviewer: Lambert, J.G. M.D.
Online Medical Reviewer: Spencer, Samantha A. MD
Date Last Reviewed: 10/31/2006
Date Last Modified: 10/31/2006