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Should Your Child See a Doctor?

Finger or Toe Injury

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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

  1. Bruised/Swollen Finger or Toe:
    • Soak in cold water for 20 minutes.
    • Give acetaminophen (e.g., Tylenol) or ibuprofen as necessary for pain relief.
     
  2. 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.
     
  3. 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.
     
  4. 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.
     
  5. 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.
     
  6. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as needed for pain relief.
  7. Shoes: If regular shoes cause too much pain, wear open-toe sandals with a firm sole until the injury heals.
  8. 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

  1. Ablove RH, Moy OJ, Peimer CA. Pediatric hand disease: Diagnosis and treatment. Pediatr Clin North Am. 1998; 45:1507-1524.
  2. Benjamin HJ, Mjannes JM, Hang BT. Getting a grasp on hand injuries in young athletes. Contemp Pedatr. 2008;25(3): 49-63.
  3. Feter-Zarzeka A, Joseph MM. Hand and fingertip injuries in children. Pediatr Emerg Care. 2002;18:341.
  4. 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.

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