Finger and Toe Injuries in Children: Jammed, Crushed, and Broken

Slammed doors, dropped objects, sports mishaps—finger and toe injuries are incredibly common in childhood. These injuries can be dramatic (lots of blood and tears), but most heal well with proper care. The key is knowing which injuries you can treat at home and which need medical attention.

Types of Finger and Toe Injuries AAP

Crush injuries:

• Finger caught in door (most common cause)
• Heavy object dropped on finger/toe
• Can damage nail, nail bed, bone

Jammed fingers:

• Impact on fingertip (catching a ball)
• Common in basketball, volleyball, football
• Can range from minor sprain to fracture

Cuts and lacerations:

• Cuts from sharp objects
• May involve nail bed
• Can be superficial or deep

Nail injuries:

• Subungual hematoma (blood under nail)
• Torn or partially detached nail
• Nail bed laceration

Fractures:

• Broken bone in finger or toe
• Not always obvious without X-ray
• May be subtle in children

Immediate First Aid AAP

Right after the injury:

1. Control bleeding

• Apply direct pressure with clean cloth
• Elevate the hand/foot
• Don't remove cloth to check—maintain pressure 10+ minutes

2. Cold compress

• Ice wrapped in cloth for 20 minutes
• Helps with pain and swelling
• Don't apply ice directly to skin

3. Assess the injury

• Can the child move the finger/toe?
• Is there obvious deformity?
• Is the nail intact?
• Is there numbness?

Crush Injuries (Door Slams) AAP

The classic "finger in the door" scenario:

What typically happens:

• Intense pain immediately
• Bruising and swelling
• Possible blood under the nail
• Nail may fall off eventually

Home treatment if:

• Finger moves normally
• No obvious deformity
• Bleeding controlled
• Sensation is normal
• Less than 50% of nail area is damaged

Treatment steps:

• Ice and elevation
• Pain relief (acetaminophen or ibuprofen)
• Protect the finger (loose bandage)
• Clean any cuts
• Watch for signs of infection

Seek medical care if:

• Finger won't bend or straighten properly
• Obvious deformity (bent at wrong angle)
• Large amount of blood under nail (>50%)
• Numbness or tingling that persists
• Cut appears deep
• Nail is partially detached at the base
• You suspect fracture

Blood Under the Nail (Subungual Hematoma) AAP

When blood collects under the nail:

Mild (less than 25% of nail):

• Painful but usually doesn't need treatment
• Ice and pain relief
• Will resolve on its own

Moderate to severe (25-50%+ of nail):

• Can be very painful due to pressure
• May need drainage (trephination) for pain relief
• This should be done by a medical professional

If nail bed is intact (nail itself damaged but nail bed not cut):

• Blood will grow out with the nail over weeks/months
• Nail may eventually fall off and regrow

Seek medical care if:

• Pain is severe and throbbing
• Blood covers more than 50% of nail
• Nail is lifting from the bed
• You suspect fracture
• The nail base is affected

Jammed Fingers and Toes AAP

Common in sports—ball impacts fingertip:

Buddy tape technique (for minor jams):

• Tape injured finger to adjacent finger
• Use medical tape with padding between fingers
• Allows protected movement
• Change tape daily

RICE treatment:

• Rest: Avoid using the finger
• Ice: 20 minutes on, 20 off
• Compression: Gentle—don't cut off circulation
• Elevation: Keep hand raised

When it might be more than a jam:

• Finger looks bent at unusual angle
• Can't bend or straighten completely
• Swelling is severe
• Pain is severe and not improving
• Symptoms last more than a week

Broken Fingers and Toes AAP

How to tell if it might be broken:

Signs suggesting fracture:

• Obvious deformity (bent wrong way)
• Severe swelling
• Bruising that spreads
• Cannot move the finger/toe
• Numbness
• Grinding sensation with movement
• Point tenderness right on the bone

Important: X-rays are often needed to confirm fractures, especially in children whose bones are still growing.

What to do:

• Immobilize the finger (splint with popsicle stick if needed)
• Ice and elevate
• Don't try to straighten it
• Seek medical care

Growth plate fractures:
Children have growth plates (areas of growing bone) that can be injured. These need proper evaluation and treatment to avoid growth problems.

Nail Injuries AAP

Partially torn nail:

• Don't pull it off—let it protect the nail bed
• Trim loose parts carefully with clean scissors
• Clean underneath gently
• Cover with non-stick bandage
• May eventually fall off naturally

Nail ripped off completely:

• Clean the nail bed gently
• Apply antibiotic ointment
• Cover with non-stick bandage
• The nail usually regrows in 4-6 months

Nail bed laceration (cut under nail):

• Often needs medical repair
• May require nail removal to repair
• Proper repair reduces chance of permanent nail deformity

When to See a Doctor AAP

Go to the emergency room for:

• Obvious fracture (deformity)
• Finger severed or nearly severed
• Severe bleeding that won't stop
• Numbness that persists
• Finger is cold or white (circulation issue)
• Deep cuts through the nail bed
• Injury at the base of the nail

See your pediatrician or urgent care for:

• Suspected fracture without deformity
• Blood under nail causing severe pain
• Wounds that may need stitches
• Concerns about infection
• Jammed finger not improving

Signs of infection (develop over days):

• Increasing redness
• Spreading warmth
• Pus or discharge
• Red streaks from the wound
• Fever
• Worsening pain

Recovery and Healing

Typical healing times:

• Minor crush injury: 1-2 weeks
• Jammed finger: 1-3 weeks
• Simple fracture: 3-6 weeks
• Nail regrowth: 4-6 months

During healing:

• Protect from re-injury
• Keep clean and dry
• Follow medical instructions for splinting
• Watch for signs of infection

Prevention Safe Kids

Door safety:

• Door guards/stoppers prevent slammed fingers
• Teach children about door dangers
• Hold doors open for young children
• Close doors slowly

Sports safety:

• Proper technique for catching
• Appropriate protective equipment
• Adequate warm-up
• Don't play through pain

Workplace/shop safety:

• Supervise use of tools
• Keep fingers clear of cutting areas
• Use guards and safety features

The Bottom Line

Most finger and toe injuries in children heal well with basic first aid: ice, elevation, and protection. But any injury with deformity, severe pain, numbness, or inability to move needs medical evaluation. When in doubt, get it checked—an X-ray can confirm whether it's a simple injury or something needing more attention.

Clara can help you assess finger and toe injuries and determine the right level of care!