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Suggest Treatment For Right Thumb Fracture With Subungual Hematoma
Question: Hi !
I slammed my thumb on the car door 10 days ago, I was at two different doctors and have done an X ray. I have small fracture on the distal bone on my right thumb and an subungual hematoma. My nail and area around my nail is dark blue-purple-black. I had bandage for one week but because the nail might fall I wear an orthosis now. I took pills for pain, for inflammation and antibiotic. Now I take only Chymoral and that's all the doctors told me, to drink the pills for 4 days. I feel pain only on touch around the nail, but what I want to know is what to do with my nail ? Should I keep it dry or put some cream ? What will happen with the hematoma around the nail ? What should i expect and what's the time needed to heal ?
Thank you !
I slammed my thumb on the car door 10 days ago, I was at two different doctors and have done an X ray. I have small fracture on the distal bone on my right thumb and an subungual hematoma. My nail and area around my nail is dark blue-purple-black. I had bandage for one week but because the nail might fall I wear an orthosis now. I took pills for pain, for inflammation and antibiotic. Now I take only Chymoral and that's all the doctors told me, to drink the pills for 4 days. I feel pain only on touch around the nail, but what I want to know is what to do with my nail ? Should I keep it dry or put some cream ? What will happen with the hematoma around the nail ? What should i expect and what's the time needed to heal ?
Thank you !
Brief Answer:
Fracture right Thumb with Subugual Hematoma
Detailed Answer:
Provisional Impression-Fracture right Thumb with Subugual Hematoma
Hi,Welcome with your query to HCM Virtual Clinic.
I meticulously studied your query details put forth by you.And I
reviewed your query details in context to the photograph of the right thumb with supporting orthosis /splint.
Ans to Your Questions are as follows-
Q-1-What to do with your nail?
I would need update of the X-ray plate and X-ray report of the Right Thumb to comment on this query.
Q-2-Should the nail be kept dry or put some cream?
From the inspection of the current photograph of the banged right thumb,You should not put any Cream on it and let it be dry.
Q-3-What will happen with the hematoma around the nail?
I could comment in better way after reviewing the Xray of the right thumb and studying the details of the Xray Report.
Q-4-What Should you expect the outcome from this banged right thumb?
I would comment on this query after study and review of the damage to the thumb tissues and bony tissues and nail,from the Xray of the right thumb.
Q-5-What is the time needed to heal this banged right thumb?
Ans- same as in 4.
Besides this I would need further information as follows-
-Is there any throbbing pain in right thumb,still?
-Is there any feverishness/bodyache any time after the accident and currently?
-Do you have any associated other medical illness currently,for which you are taking any other drugs? if so, name the drugs.
-Any lab test reports done?please update them.
Suggestions till next review-
-Continue with Chymoral
-REST and ELEVATION OF THE RIGHT THUMB AND RIGHT FOREARM AND ARM.
-Tab-Zincovit
Await your information by tomorrow.
Welcome for any further query in this regard.
Good Day!!
Dr.Savasaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Fracture right Thumb with Subugual Hematoma
Detailed Answer:
Provisional Impression-Fracture right Thumb with Subugual Hematoma
Hi,Welcome with your query to HCM Virtual Clinic.
I meticulously studied your query details put forth by you.And I
reviewed your query details in context to the photograph of the right thumb with supporting orthosis /splint.
Ans to Your Questions are as follows-
Q-1-What to do with your nail?
I would need update of the X-ray plate and X-ray report of the Right Thumb to comment on this query.
Q-2-Should the nail be kept dry or put some cream?
From the inspection of the current photograph of the banged right thumb,You should not put any Cream on it and let it be dry.
Q-3-What will happen with the hematoma around the nail?
I could comment in better way after reviewing the Xray of the right thumb and studying the details of the Xray Report.
Q-4-What Should you expect the outcome from this banged right thumb?
I would comment on this query after study and review of the damage to the thumb tissues and bony tissues and nail,from the Xray of the right thumb.
Q-5-What is the time needed to heal this banged right thumb?
Ans- same as in 4.
Besides this I would need further information as follows-
-Is there any throbbing pain in right thumb,still?
-Is there any feverishness/bodyache any time after the accident and currently?
-Do you have any associated other medical illness currently,for which you are taking any other drugs? if so, name the drugs.
-Any lab test reports done?please update them.
Suggestions till next review-
-Continue with Chymoral
-REST and ELEVATION OF THE RIGHT THUMB AND RIGHT FOREARM AND ARM.
-Tab-Zincovit
Await your information by tomorrow.
Welcome for any further query in this regard.
Good Day!!
Dr.Savasaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
The throbbing pain is gone, no feverishness or bodyache after the accident, no other medical illnesses and I haven't been taking any drugs lately. Also I haven't done any lab tests, only the X ray. The X ray is taken one week ago. These are the best photos I could take.
Thank You !
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Fracture- Distal Phalanx of the right Thumb with Subugual Hematoma
Detailed Answer:
Provisional Impression(after xray updates)
-Fracture- Distal Phalanx of the right Thumb with Subugual Hematoma
Hi,Thanks for the 4 updated X-ray photos of the Right Thumb
I meticulously reviewed your query details in context to the 4 X-ray photograph of the right thumb .
Ans to Your Questions are as follows-
Q-1-What to do with your nail?
After Studying the updated X-ray plate, you just have to protect the nail,though the distal phalanx of the First finger/Thumb appears to be fractured with crushing force of the car door.
The nail and the subungual tissue on the photo of the right thumb,has responded well to the anti-inflammatory and chymoral treatment for last 10 days time.
And I am hopeful in this context,that the results should be hopeful.
So I would suggest you not to disturb the nail and protect from any trauma/or from any water clogging to avoid any infection.
Q-2-Should the nail be kept dry or put some cream?
From the inspection of the current photograph of the banged right thumb,You should not put any Cream on it and let it be dry.I maintain the same opinion after review of the 4 Xray plates.
Q-3-What will happen with the hematoma around the nail?
After reviewing the Xray of the right thumb with your coloured photo of the right thumb,I expect the hematoma to resolve but bit late than usual due the crushing trauma to the bone and subungual tissue,because of the delayed recovery of the tissue edema in the subungual and surrounding hematoma around the nail.
If the rest and immobilization is extended till 6-8 weeks or more,chances of recovery of the hematoma by collagen and bony matrix is bound to give good foundation for the nail and the nail plate superficial to hematoma.
So immobilization for 6-8 weeks is the key to better recovery of the the nail and the hematoma around it.
Q-4-What Should you expect the outcome from this banged right thumb?
After study and review of the damage to the thumb tissues and bony tissues and nail,as perceived from the crushed base of the distal phalanx and ant. part of the head of the Proximal phalanx of the right thumb,as seen on the Xray of the right thumb,indicates that-for better tissue function and recovery, key to success is extended Immobilization of the distal and proximal phalanx of the right thumb for 6-8 weeks,with gradual mobilization of the recovered thumb.
The extended time would give better functioning thumb and patience till that time and management of the crushed soft tissue,is the challenging jobs for the treating doctor /orthopedic surgeon.
Q-5-What is the time needed to heal this banged right thumb?
Ans- In reference to above explanations,the time required is 6-8 weeks in total,and would be 2-4 weeks more than the routine fractures(which heal by 4-6 weeks time),and this extended time is required to allow proper healing of the soft and bony structures around the subungual nail plate,so as to get the better functioning thumb.
Besides this I would suggest further special care as follows-
-Continue with Chymoral till another 2-4 weeks more for better tissue recovery and healing.
-Add up Tab Vit D3 with Calcium x for 4-8 weeks
-REST and ELEVATION OF THE RIGHT THUMB AND RIGHT FOREARM AND ARM-is the essence of successful recovery of the right thumb.
-High protein diet with Citrus fruits would recoup the soft tissue and fracture bones fast in the right thumb.
-Tab-Zincovit to supplement fast recouping of general health.
Q-6-Whether nail can be saved or not?-
I would keep My fingers crossed on this issue,though we are making all the efforts to save it by the above planned suggestions.Nail saving is of questionable outcome,due to very bad crushed nail plate and distal phalanx.
Hope this reply would resolve all your queries and would reduce your anxiety accompanied with it.
Hope you are satisfied with this reply,which would help you to plan better treatment with your doctors there.
Will appreciate your writing excellent comments to help the needy patient visitors like you at My Virtual Clinic at HCM.
Welcome for any further query in this regard,before I close this query from my side,which I would love to attend to your satisfaction.
Wishing fast and successful recovery to you.
Good Day!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Detailed Answer:
Provisional Impression(after xray updates)
-Fracture- Distal Phalanx of the right Thumb with Subugual Hematoma
Hi,Thanks for the 4 updated X-ray photos of the Right Thumb
I meticulously reviewed your query details in context to the 4 X-ray photograph of the right thumb .
Ans to Your Questions are as follows-
Q-1-What to do with your nail?
After Studying the updated X-ray plate, you just have to protect the nail,though the distal phalanx of the First finger/Thumb appears to be fractured with crushing force of the car door.
The nail and the subungual tissue on the photo of the right thumb,has responded well to the anti-inflammatory and chymoral treatment for last 10 days time.
And I am hopeful in this context,that the results should be hopeful.
So I would suggest you not to disturb the nail and protect from any trauma/or from any water clogging to avoid any infection.
Q-2-Should the nail be kept dry or put some cream?
From the inspection of the current photograph of the banged right thumb,You should not put any Cream on it and let it be dry.I maintain the same opinion after review of the 4 Xray plates.
Q-3-What will happen with the hematoma around the nail?
After reviewing the Xray of the right thumb with your coloured photo of the right thumb,I expect the hematoma to resolve but bit late than usual due the crushing trauma to the bone and subungual tissue,because of the delayed recovery of the tissue edema in the subungual and surrounding hematoma around the nail.
If the rest and immobilization is extended till 6-8 weeks or more,chances of recovery of the hematoma by collagen and bony matrix is bound to give good foundation for the nail and the nail plate superficial to hematoma.
So immobilization for 6-8 weeks is the key to better recovery of the the nail and the hematoma around it.
Q-4-What Should you expect the outcome from this banged right thumb?
After study and review of the damage to the thumb tissues and bony tissues and nail,as perceived from the crushed base of the distal phalanx and ant. part of the head of the Proximal phalanx of the right thumb,as seen on the Xray of the right thumb,indicates that-for better tissue function and recovery, key to success is extended Immobilization of the distal and proximal phalanx of the right thumb for 6-8 weeks,with gradual mobilization of the recovered thumb.
The extended time would give better functioning thumb and patience till that time and management of the crushed soft tissue,is the challenging jobs for the treating doctor /orthopedic surgeon.
Q-5-What is the time needed to heal this banged right thumb?
Ans- In reference to above explanations,the time required is 6-8 weeks in total,and would be 2-4 weeks more than the routine fractures(which heal by 4-6 weeks time),and this extended time is required to allow proper healing of the soft and bony structures around the subungual nail plate,so as to get the better functioning thumb.
Besides this I would suggest further special care as follows-
-Continue with Chymoral till another 2-4 weeks more for better tissue recovery and healing.
-Add up Tab Vit D3 with Calcium x for 4-8 weeks
-REST and ELEVATION OF THE RIGHT THUMB AND RIGHT FOREARM AND ARM-is the essence of successful recovery of the right thumb.
-High protein diet with Citrus fruits would recoup the soft tissue and fracture bones fast in the right thumb.
-Tab-Zincovit to supplement fast recouping of general health.
Q-6-Whether nail can be saved or not?-
I would keep My fingers crossed on this issue,though we are making all the efforts to save it by the above planned suggestions.Nail saving is of questionable outcome,due to very bad crushed nail plate and distal phalanx.
Hope this reply would resolve all your queries and would reduce your anxiety accompanied with it.
Hope you are satisfied with this reply,which would help you to plan better treatment with your doctors there.
Will appreciate your writing excellent comments to help the needy patient visitors like you at My Virtual Clinic at HCM.
Welcome for any further query in this regard,before I close this query from my side,which I would love to attend to your satisfaction.
Wishing fast and successful recovery to you.
Good Day!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thank You very much about your answers, I am very satisfied with the answers and I will follow your advices. This was very helpful to me. Thanks again.
Brief Answer:
Hi,Welcome and keep Updated !!
Detailed Answer:
Hi,Thanks for the appreciative comments.
Will appreciate writing your strong and excellent review comments to help needy patient visitors like you at HCM virtual clinic.
Welcome for any further query from your friends and foes from your country or by direct question for ME.
Keep Updated for any help you need in time to come!!
Wishing fast and successful recovery to you.
Good Day!!
Regards,
Dr.Savaskar M.N. XXXXXXX Surgical Specialista
M.S.Genl-CVTS
Hi,Welcome and keep Updated !!
Detailed Answer:
Hi,Thanks for the appreciative comments.
Will appreciate writing your strong and excellent review comments to help needy patient visitors like you at HCM virtual clinic.
Welcome for any further query from your friends and foes from your country or by direct question for ME.
Keep Updated for any help you need in time to come!!
Wishing fast and successful recovery to you.
Good Day!!
Regards,
Dr.Savaskar M.N. XXXXXXX Surgical Specialista
M.S.Genl-CVTS
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
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