Suturing/Subungal Hematoma

Ok sign

Four digital nerves per digit. palmer nerves dominant, digital nerves immediately adjacentto phalanges

Intodorsal lateral aspect of proximal phalanx in web space, distal to MTP joint @ 90 degree angle, inject .5 ml

1-2 ml, wait 20 min for total block, place a half ring around digit by injecting over and under the bone

Infection and hematoma, avoid multiple needle insertions, vascular puncture (ankle),avoid epinephrine solutions, nerve injury, systemic shoc

Accumulation of blood between the nail plate and nail bed

R/o fracture, infection, extensive injury, swelling, redness and temperature

Elevate finger, cool compress, bandage during first 24 hr, call for persistent pain, purulent discharge, change in sensation or fever

Vertial dark-brown band on nail that expands to surrounding skin, nail brittleness and cracking, nodule underneath w/ or without pigment ban