Evacuation of the hematoma not only provides immediate pain relief but also aids in minimizing additional damage to the nail bed and nail matrix. When the lesion is less than 48 hours old, piercing of the nail plate overlying the hematoma (referred to as trephination) can be performed using any of the following modalities: a hot paper clip cautery (held with a hemostat), a hot No. 18 needle, a hand engine with a dental bur, a scalpel blade used as a drill, or a hand-held cautery unit. The heated trephine is directed perpendicular to the nail plate overlying the hematoma; slow and gentle pressure is applied cautiously until blood exits from the nail plate surface. If the lesion is older than 48 hours, the blood may no longer be free flowing and avulsion of the nail plate may be necessary to evacuate the hematoma.
The affected digit often correlates with the sport the 4th and 5th toes in runners and joggers, the 2nd and 3rd toes in soccer and squash players, and the great toe in tennis players.
Lesson of the Day: Be nice to ladies with black toes, they suffer in slience. haha... just joking.
Thought of the Day: I have a hidden tennis talent. =p