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Pediatric - Finger or Toe Injury

Finger or toe injury

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First Aid - Amputated Finger or Toe - Transport
First Aid - Amputated Finger or Toe - Transport

First Aid - Bleeding Finger
First Aid - Bleeding Finger

First Aid - Bleeding Toe
First Aid - Bleeding Toe

First Aid - Removing a Splinter
First Aid - Removing a Splinter

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

If not, see these topics

When to Call Your Doctor

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 and 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 and 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 and 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 "Call Your Doctor" symptoms.

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: 1/19/2009

Last Revised: 6/17/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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