Definition: A black toenail (subungual hematoma) in a build up of blood beneath the nail plate. If may be acute, due to stubbing the toe or dropping a heavy object on the toe or chronic, due to repeated friction of the nail.
- Acute or chronic injury to the nail.
- Improper fitting shoes (too short, not enough room in the toe box)
- Repeated jamming of toes in boots, especially going downhill grades
- Acute pain in the toenail
- Minimal pain but discoloration of the nail
- Occasional bleeding and drainage from beneath the nail
- If pain is acute, the hemorrhage beneath the toenail must be drained.
- In the field this can be done by heating a paperclip or sharp instrument and applying it to the nail plate until drainage occurs.
- If you have access to a physician or clinic, they can decompress the nail with a high-speed drill or electrocautery.
- Chronic non-painful cases can be left alone. The nail will often grow out and eventually fall off leaving a new nail beneath it.
- Careful fitting of shoes and socks.
- Avoidance of acute injuries to the toes
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