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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child With Injury To Thumb. Has A Blood Clot On The Finger. Combiflam Prescribed. Nail Turned Black With Swelling. What To Do?

I have 2.3yrs old daughter. She kept her thumb finger in between the car door and i closed it unknowingly. She cried a lot and there was no external bleeding . But i could see the impact on her finger nail and blood clot inside. A local doctor prescribed combilflam 5ml 3 times a day. But today i can see her finger a bit swollen and the total nail has turned black. Please let me know what to do.
Fri, 5 Apr 2013
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General & Family Physician,  's  Response
Dear Pradeep

Welcome to HCM and thanks for posting your query here.

Whenever an injury occurs to soft tissue it results in swelling and depending on the stress there will be blood clot or bleeding. The swelling will start from the time of injury and peaks for 2 days. As you said the injury is to the finger nail. It will be a big hurt to a small kid. Of course dont worry. She will be alright. The black colour is due to changes in the blood clot. The clotted blood will turn from red to black to yellow and to green within a span of 10 days. It is a normal mechanism.

I suggest you to use a simple antibiotic like amoxycillin for 5 days. Because injury to nail bed in children may some times lead to abscess formation. In the mean time you can use some topical antiseptics like povidone iodine ointment.

Dont get worried. She will be fine. Next time take more care when the little angel is around you.

Hope this is helpful to you.
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Pediatrician, Surgery,  Dr. Jai Bharat Panwar 's  Response
Hello, Consult Pediatric Surgeon and carry x-ray of that hand. If no fracture then no worry. Black nail may be because of collection of blood below nail. Need not to worry that nail may be removed itself and replaced by new nail.
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Child With Injury To Thumb. Has A Blood Clot On The Finger. Combiflam Prescribed. Nail Turned Black With Swelling. What To Do?

Dear Pradeep Welcome to HCM and thanks for posting your query here. Whenever an injury occurs to soft tissue it results in swelling and depending on the stress there will be blood clot or bleeding. The swelling will start from the time of injury and peaks for 2 days. As you said the injury is to the finger nail. It will be a big hurt to a small kid. Of course dont worry. She will be alright. The black colour is due to changes in the blood clot. The clotted blood will turn from red to black to yellow and to green within a span of 10 days. It is a normal mechanism. I suggest you to use a simple antibiotic like amoxycillin for 5 days. Because injury to nail bed in children may some times lead to abscess formation. In the mean time you can use some topical antiseptics like povidone iodine ointment. Dont get worried. She will be fine. Next time take more care when the little angel is around you. Hope this is helpful to you.