Subungual Hematoma Drainage

Overview

4.6 out of 5 (21 Reviews)

Credits

1.00

Post-Assessment Questions

5

Start Date

1 Sep 2023

Last Review Date

24 Jun 2025

Expiration Date

31 Aug 2026

Estimated Time To Finish

60 Minutes


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Activity Description

Subungual hematomas result from bleeding beneath the nail due to nail bed trauma, commonly caused by direct blows or crush injuries to the distal phalanx. Patients typically present with pain, nail discoloration, and visible subungual blood accumulation. Accumulating pressure beneath the nail can lead to severe discomfort. A physical examination should assess the entire nail structure, including motor function, sensation, and vascular integrity. Imaging, such as radiographs or point-of-care ultrasound, helps identify distal phalanx fractures or nail bed lacerations. Most subungual hematomas are effectively treated with trephination, a procedure that relieves pressure by creating a hole in the nail. However, larger hematomas or those with suspected underlying injuries may necessitate removal of the nail plate and surgical repair.

This activity enhances clinician competence in evaluating and managing subungual hematomas using current evidence-based guidelines. Participants learn to differentiate cases requiring simple trephination from those necessitating nail plate removal and nail bed repair. Emphasis is placed on appropriate assessment, imaging, and procedural technique. Collaboration within an interprofessional team—comprising clinicians, nurses, radiologists, and wound care specialists—optimizes patient outcomes by ensuring timely diagnosis, effective treatment, and coordinated follow-up care. Through improved clinical decision-making and communication, this course supports more accurate and comprehensive management of subungual hematomas.


Target Audience

This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, and nurse practitioners.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Identify the anatomical structures of the nail unit and common mechanisms of injury leading to subungual hematomas.

  • Differentiate between simple subungual hematomas amenable to trephination and complex injuries requiring nail plate removal and nail bed repair.

  • Develop communication strategies to educate patients with subungual hematomas about their diagnosis, treatment options, and the rationale for conservative versus surgical management.

  • Collaborate with the interprofessional team to educate, treat, and monitor patients with subungual hematoma to improve health outcomes.

Disclosures

StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

 

Physicians and Physician Associates: StatPearls, LLC designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. Physicians and PAs should only claim credit commensurate with the extent of their participation in the activity.

American Board of Pathology: Successful completion of this Continuing Certification activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Lifelong Learning (CME) credits in the American Board of Pathology’s Continuing Certification Program.

American Board of Pediatrics: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

American Board of Surgery: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and Self-Assessment requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

Royal College of Physicians and Surgeons of Canada: Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Please consult your professional licensing board for information on the applicability and acceptance of continuing education credit for this activity.

Method of Participation and Credit

  1. Register for the activity.    
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content of the enduring material.
  4. Choose the best answer to each activity test question. To receive credit and a certificate, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment survey.

If you have concerns regarding the CE/CME system, please contact support@statpearls.com.

Disclaimer

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the FDA. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls expressly disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Unapproved Uses of Drugs/Devices: In accordance with FDA requirements, the audience is advised that information presented in this continuing education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA-approved package insert for each drug/device for full prescribing/utilization information.

Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.

 

 
 

Reviews

Howard S. on 9/11/2021

Jarrod H. on 11/2/2021

rebecca n. on 12/18/2021

Howard S. on 2/27/2022

Daniel D. on 3/22/2022

Christopher H. on 11/9/2022

Peter M. on 11/23/2022

Khader M. on 12/18/2022

Lily L. on 5/24/2023

Denise W. on 10/22/2023

Russell J. on 10/27/2023

Cassie S. on 11/3/2023

The 5 year old question was a little confusing, as I would want to get an assessment of ROM and xrays before proceeding with trephenation.

Garrett A. on 1/14/2024

Liz C. on 1/20/2024

Amber F. on 3/25/2024

Thomas B. on 7/15/2024

Timothy H. on 11/10/2024

Richard D. on 1/15/2025

Josiah B. on 3/14/2025

Randy F. on 3/30/2025

Mark K. on 4/25/2025

Unlimited Physician CME

Stay up to date on the latest medical knowledge with 6689 CME activities. In these online self-assessment activities, read our reference articles and test your knowledge with more than 7951.5 hours of CME.

Learn About Lifetime CME

Single Activity

Take this single activity

$49 1 activity

6 Month Unlimited Physician CME

Access to all the Unlimited Physician CME activities in all specialties.

$329 per half year per user

1 Year Unlimited Physician CME

Access to all the Unlimited Physician CME activities in all specialties.

$499 per 1 year per user