No is the straightforward answer in most cases. A 1991 study assessed the safety and effectiveness of treating simple subungual hematomas (SUH) using nail trephination alone, without nail removal or suture repair.
Over a two-year period, clinicians treated 48 eligible patients with nail trephination using electrocautery. They used radiographs to identify distal phalangeal fractures and measured SUH size. All patients experienced pain relief after the procedure. Clinicians completed follow-up in 45 of 48 patients over an average of 10.3 months.
Clinicians reported no complications such as infection, osteomyelitis or major nail deformities in patients treated with nail trephination. This applied regardless of SUH size or the presence of a fracture. The study concludes that, in simple SUH cases, nail removal with suture repair is unnecessary.
David C. Seaberg, William J. Angelos, Paul M. Paris, Treatment of subungual hematomas with nail trephination: A prospective study, The American Journal of Emergency Medicine, Volume 9, Issue 3,
1991.
