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Three Part Question

[Patient with subungal hematoma]does [trephine drianage veruse non -trephine drainge] improve [ pain severity]

Clinical Scenario

A 51 year old female patient attends the emergency department with a history of ally trapped her right index finger in a door and developed subungual haemotoma. X-ray was done showed no bony injury. The skin and nail bed margin were intact. You wonder is it safe to simple trephining drainage this subungal haematoma to reduce the pain severity

Search Strategy

Medline using the OVID interface 1996-09/05.
[Exp hematoma OR haematoma$.mp OR exp subungual haemotoma OR subungual haematoma.mp] And [Exp hematoma OR haematoma$.mp OR exp subungual haemotoma OR subungual haematoma.mp] limit to human and English.
Medline using the OVID interface 1996-09/05.
[Exp hematoma OR haematoma$.mp OR exp subungual haemotoma OR subungual haematoma.mp] And [Exp hematoma OR haematoma$.mp OR exp subungual haemotoma OR subungual haematoma.mp] limit to human and English.

Search Outcome

Altogether 8 papers found of which none were relevant to the original question

Comment(s)

Despite the fact that many emergency doctors hold firm views about simple trephining drainage is better than non-trephining drainage in subungual haemotoma but there is no published evidence to inform a decision.

Clinical Bottom Line

Local advice should be followed