Finger or Toe Injury

What is a finger or toe injury?

Common injuries include bruises, cuts, torn nails, or jammed fingers. Bruising and swelling is usually caused from the soft tissues and underlying bones being smashed or hit.

In crush injuries (as from slammed car doors), usually the end of the finger or toe receives a few cuts. Occasionally the nail is damaged and the nailbed requires stitches. Rarely is there any fracture of the small underlying bone.

A jammed finger occurs if the end of a straightened finger or thumb receives a blow (usually from a ball). The energy is absorbed by the joint surfaces and the injury occurs at the joint. If a finger is jammed, always check carefully that your child can bend and then fully straighten his or her finger.

How can I take care of my child?

• Bruised finger or toe

  Soak it in cold water for 20 minutes. Give your child acetaminophen or ibuprofen as necessary for the pain. Call your child's health care provider if the pain is not improving by 3 days.

• Jammed finger

  Soak the hand in cold water for 20 minutes. Give acetaminophen or ibuprofen as necessary for the pain. (Avoid aspirin because it may prolong the bleeding.) It's going to be sensitive for the next week, so protect it by "buddy-taping" it to the next finger. A splint could be used but often makes it more prone to getting bumped. Call your child's health care provider if the pain is not improving within 3 days.

• Smashed or crushed fingertip

  Before taking care of this yourself, check the guidelines on when to call your child's health care provider below.

  Soak the hand in cold water for 20 minutes. Give your child acetaminophen or ibuprofen as necessary for the pain. (Avoid aspirin because it may prolong the bleeding.) Call your child's health care provider if any signs of infection develop or the pain hasn't improved in 3 days.

• Torn nail

  These recommendations apply to a nail that has been torn by catching on something. If the nail was torn by a crush injury, your child needs to see a doctor. If the nail is cracked but there are no rough edges, leave it alone.

  If the nail is almost torn through or there is a large flap of nail, use sterile scissors or nail clippers to cut along the line of the tear. Pieces of nail taped in place will catch on objects. Soak the finger for 20 minutes in cold water. Apply an antibiotic ointment (such as bacitracin or Betadine) and cover it with a Band-Aid. Each day, remove the dressing and soak the finger in a warm salt solution (1/2 teaspoon of salt to a pint of water).

  By the seventh day, the nailbed should be covered with new skin, and both the soaking and the bandaging can be stopped. A new nail will grow in over the next 1 to 2 months. Call your child's health care provider if you see any signs of infection.

• Cuts

  Wash the wound vigorously with soap and water for 5 minutes. Then apply pressure for 10 minutes with a sterile gauze to stop bleeding. Leave the area exposed to the air.

• Skinned knuckles

  These wounds are deep scrapes of the upper surfaces of fingers or toes. Wash the wound vigorously for 5 minutes with water and liquid soap. Scrubbing with a sterile gauze may be necessary to get all the dirt out. Flaps of skin (especially if they are dirty) should be cut off with sterile scissors. When the wound is clean, apply pressure for 10 minutes with a sterile gauze to stop any bleeding. Apply an antibiotic ointment and cover with a Band-Aid. Remove the dressing and clean the wound each day. Call your child's health care provider if you see any signs of infection.

• Ring caught on swollen finger

  In most cases, the ring can be saved rather than cut off. The key to removing the ring is reducing the swelling of the finger. This approach requires patience. At 5-minute intervals, alternate soaking the hand in cold water and holding it (with all the fingers straightened) high in the air. At 30 minutes (after the hand has been elevated for the third time), put mineral oil or cooking oil on the finger. While the hand remains elevated, push the ring with steady upward pressure until it slides off. If it won't slide off, call your child's health care provider immediately before the swelling becomes worse.

When should I call my child's health care provider?

Call IMMEDIATELY if:

• The skin is split open and may need stitches.
• Blood collects under a nail AND becomes very painful.
• There is any dirt or grime in the wound you can't get out.
• A crush injury has damaged the skin or fingernail.
• A finger can't be opened (straightened) and closed (bent) completely.

Call during office hours if:

• The injury looks infected.
• Your child is not using the finger or toe normally after 1 week.
• You have other questions or concerns.