Ушиб ногтя на руке представляет собой довольно распространенную травму. Способов получить такое повреждение огромное множество, поэтому предугадать данный момент почти невозможно. Ушиб пальца вызывает формирование гематом под ногтевой пластиной, характеризующихся сине-черным оттенком в поврежденной области. Наиболее тяжелой травмой является поражение, нарушающее кровообращение, ввиду чего ушибленный ноготь начинает отторгаться. Болевой симптом в этом случае настолько сильный, что человек может потерять сознание.
Причины и симптомы
Ушиб ногтя является очень распространенным повреждением, поэтому говорить о причинах можно только в обобщенном виде. Согласно статистике, большинство людей получают травмы такого характера в результате удара пальцем о жесткую поверхность или падения на него тяжелого предмета. Примерно 10% данных повреждений происходит в результате ущемления пальцев рук. Такое явление наиболее распространено среди детей.
Симптомы травмы ногтя довольно неспецифичны, поэтому необходимо осуществление диагностических процедур, позволяющих исключить вероятность перелома пальца. Заниматься диагностикой должен врач.
Сам пострадавший может наблюдать у себя следующие признаки:
- Болевые ощущения в области поврежденного ногтя – в мягких тканях, которые расположены под ногтем, находится огромное количество нервных окончаний, поэтому болевой синдром при ушибе очень сильный. Исключения могут составлять повреждения незначительного характера, которые сопровождаются симптоматическим комплексом. При этом наблюдаются боли тупого, пульсирующего типа.
- Нарушение двигательной способности пораженного пальца – в этом случае ухудшение функции никак не связано с изменениями органического вида в конечности, однако человеку очень сложно пошевелить пальцем. Это происходит в результате иррадиирования боли от пораженной области по нервным окончаниям. Поэтому болевой симптом может затрагивать область, находящуюся далеко за пределами ногтевой пластины.
- Неприятные ощущения в районе повреждения – дискомфорт, сопровождающий травму с самого начала, может иметь вид распирания или ощущения тяжести под ногтевой пластиной. Такой симптом появляется вследствие образования гематомы (синяка), которая может значительно приподнимать пластину.
- Отечность в поврежденной области – данное явление чаще всего связано с большим скоплением жидкости в пораженных тканях. В этом случае отек может быть синего цвета и иметь значительные размеры.
- Синий оттенок ногтевой пластины – в нормальном состоянии данная область имеет светло-серый цвет и матовую текстуру полупрозрачного оттенка. Это объясняется интенсивным процессом кровообращения в мягких тканях под ногтем. Появление синюшного оттенка обусловлено образованием гематомы. В большинстве случаев изменение оттенка начинается примерно через 9-12 часов после травмирования.
- Отторжение ногтевой пластины – данный симптом появляется в том случае, если образуется гематома, затрагивающая большой участок.
Первая помощь
Начинать лечение необходимо сразу же после получения травмы. В результате повреждения образуется кровоподтек, который вызывает значительные болевые ощущения. Пока гематома не будет устранена, данные симптомы станут мучить человека. В этом случае происходит покраснение пальца и образование отека, что может свидетельствовать не только об ушибе, но и о переломе пальца. Поэтому очень важно пройти обследование у врача, для того чтобы исключить вероятность повреждения костной ткани.
Так как травмирование ногтя на руке сопровождается усиленной чувствительностью нервных волокон и постоянным ощущением боли, необходимо в первую очередь устранить данный симптом.
Первая помощь и лечение ушиба ногтя включают в себя следующие мероприятия:
- Рекомендуется принять горизонтальное положение. Травмированную конечность следует поднять вверх. Это поможет уменьшить боль, поскольку кровь будет поступать к пораженной области менее интенсивно.
- Приложить к ушибленному месту холод. По мере нагревания предмета необходимо периодически заменять его.
- В обязательном порядке нужно продезинфицировать поврежденную область перекисью водорода или спиртом.
- Если боль слишком интенсивная, рекомендуется принять обезболивающий препарат.
В случае если ушиб был очень сильным и наблюдается потемнение не только ногтевой пластины, но и кожного покрова вокруг него, имеется большой риск, что ноготь начнет отслаиваться. Чтобы избежать такого явления, необходимо тщательно обработать кожу йодом, плотно заклеить пластырем и как можно быстрее посетить медицинское учреждение. Специалист поможет обеспечить необходимые условия для того, чтобы скопившаяся кровь смогла выйти наружу. Это значительно уменьшит объем гематомы.
Проводить такую процедуру в домашних условиях категорически запрещено, поскольку это может привести к заражению крови.
В каких случаях обращаться к врачу?
Вылечить легкую степень ушиба можно самостоятельно, однако очень часто травма приобретает более серьезный характер, что делает поход к врачу обязательным условием эффективного восстановления.
Помимо признаков местного характера, в наиболее тяжелых случаях могут появиться следующие симптомы:
- головные боли;
- повышенная температура тела;
- тошнота;
- постоянная слабость.
Такие признаки говорят о развитии воспалительного процесса в пораженной области или попадании инфекции в кровь. В этом случае обязательно нужно обратиться к врачу. Осуществлять лечение самостоятельно запрещено, поскольку это может быть опасно не только для здоровья, но и для жизни.
Многие люди игнорируют появление ушиба ногтя на руке, что делать категорически нельзя. Такое отношение к проблеме чревато серьезными последствиями. Неправильное лечение ушиба ногтевой пластины может привести к развитию косметических дефектов, поскольку отросший ноготь после отторжения способен иметь неэстетичный вид. Если женщина может спрятать данную проблему в ярком маникюре, мужчинам сделать это не удастся. Поэтому не следует игнорировать такую травму. Лечение должно осуществляться под контролем врача.
Ушиб ногтя на руке – это достаточно частая и серьезная травма, при которой происходит повреждение ногтевой пластины и мягких тканей пальца. По клиническим симптомам она может напоминать перелом.
Чаще всего такие травмы получают в быту, пальцы руки страдают от ударов тяжелыми предметами или защемления между твердыми поверхностями. Возможно повреждение во время занятий спортом. В большинстве случаев травмируются указательный и большой пальцы.
Механизм образования подногтевой гематомы
При ушибе ногтя повреждаются нервы и мелкие сосуды, кровь изливается в мягкие ткани, образуя гематому. В результате отека сдавливаются нервные окончания, которых в данной области много, это приводит к возникновению очень сильной боли. Ногтевая пластина достаточно плотная, из-за этого в тканях создаются участки высокого давления, что усиливает болевые ощущения.
Появлению гематом и синяков под ногтями способствуют переломы, растяжения связок, а также болезни, которые влияют на состояние кровеносных сосудов и ослабляют их стенки (цинга, сахарный диабет).
Причиной окрашивания ногтя становится кровь. Изначально она красного цвета, но недостаток кислорода под ногтевой пластиной приводит к быстрому разрушению эритроцитов и гемоглобина, в результате чего появляется синий цвет. При высыхании крови в негерметичной полости гематомы ноготь приобретает черный цвет.
Виды ушиба
В зависимости от тяжести повреждения, различают следующие степени травмы:
- легкая. Повреждения незначительные, в некоторых случаях поражаются мягкие ткани. В течение суток проблема исчезает самостоятельно;
- средней степени тяжести. Повреждается ногтевая пластина, в области травмы возникает гематома (ноготь синеет); если это случилось, в дальнейшем пластина может отслаиваться;
- тяжелая. Повреждается ногтевая пластина, возникает сильный отек и кровоизлияние. Может наблюдаться вывих пальца, а также трещины и переломы кости, ногтевая пластина отслаивается.
Симптомы
В результате проведенных исследований был выявлен тот факт, что сразу после механического повреждения мягких тканей в области ногтя на руке или ноге (без перелома костей) возникает гипертермия, покраснение, припухлость и болезненность. С помощью инфракрасной термографии было установлено, что через 10 секунд температура ушибленного участка повышается на 1,0–1,5 °C.
Температура ногтевой пластинки над гематомой через 5 минут становится выше, чем в средней фаланге этого же пальца на 3,0–3,5 °C. На этом уровне она держится до трех часов.
Характерные признаки ушиба:
- палец опухает, ноготь становится багровым или вишнево-синим. Размер и форма синюшной зоны зависит от локализации и силы удара;
- процесс образования гематомы сопровождается болевыми ощущениями. В результате образования зоны высокого давления боль становится очень интенсивной, распирающей, дергающей.
Через 1–2 дня болевые ощущения уменьшаются, температура приходит в норму, а ноготь приобретает синий или сине-черный цвет. Если травма закрытая, то в большинстве случаев гнойный процесс не присоединяется, но отек может распространяться на весь палец.
Поврежденный ноготь растет, и вместе с этим темное пятно под ногтевой пластиной постепенно перемещается. Через некоторое время цвет сменяется на синий, затем на черный. Поврежденная ногтевая пластина полностью заменяется за 1–3 месяца.
При падении на выпрямленный палец или ударе по торцевой части может возникнуть подкожный разрыв сухожилий сгибателя:
Вид разрыва сухожилия
Ногтевая фаланга полностью сгибается, при этом разгибательные движения отсутствуют
Сгибательные движения сохраняются, но полное сгибание пальца невозможно
Что делать при ушибе ногтя на руке
Первая помощь
Если на пальце есть кольцо, его нужно снять в первую очередь, поскольку в дальнейшем из-за нарастающей отечности это сделать не получится. Для того чтобы избежать образования гематомы, палец подставляют под струю холодной воды, прикладывают к нему холодный компресс или лед. Это поможет сузить сосуды и уменьшить болевые ощущения. Холод прикладывают на 10 минут, затем делают перерыв.
При выявлении ссадин или порезов, их обрабатывают антисептиками (Перекисью водорода, Хлоргексидином, Зеленкой или Йодом). При частичной отслойке ногтя рану промывают, а для того чтобы предотвратить дальнейшую травматизацию, накладывают повязку с обезболивающей мазью.
Для этих целей используют бинт, марлю или отрез ткани. Не стоит приклеивать поврежденный ноготь лейкопластырем, так как снять его в дальнейшем будет сложно. Процедура будет очень болезненной, а если ногтевая пластина отслоилась, ее можно сорвать полностью.
После того как первая помощь была оказана, пациента необходимо доставить в травмпункт, для того чтобы врач исключил сложные травмы, такие как перелом или вывих. Определить их можно с помощью рентгена.
Лечение ушиба ногтя
Лечение ушиба проводят амбулаторно. При наличии подногтевых гематом, их вскрывают, прокалывая иглой ногтевую пластину. Поскольку в ней нет нервных окончаний, то эта процедура не слишком болезненна. Но при сильных ушибах возможно введение обезболивающих препаратов.
При крупных ногтевых гематомах может потребоваться удаление ногтя. Это достаточно серьезная и болезненная процедура с длительным периодом реабилитации, которую выполняют под местным наркозом.
Для того чтобы уменьшить болевые ощущения при ушибе, пациенту рекомендуют обезболивающие препараты на основе кеторолака (Кетанов, Кеторол), нимесулида (Нимид, Нимесил, Нимедар) или ибупрофена (Нурофен, Ибупром). Препараты принимают согласно с инструкцией 2–3 раза в сутки после еды.
В первые часы после травмы, по возможности, конечность нужно держать приподнятой. При подкожном разрыве сухожилия, переломах и трещинах костей на пальцы налагают гипсовую лангету или фиксирующую повязку.
Средства народной медицины
Вылечить ушиб в домашних условиях помогут следующие народные средства:
- рецепт №1: столовую ложку картофельного крахмала разводят теплой водой до консистенции густой сметаны. Средство наносят на поверхность пальца. После того как кашица застынет, ее смывают теплой водой и используют повторно. Такую процедуру проводят до облегчения симптомов;
- рецепт №2: смешивают по одной чайной ложке соды и морской соли и растворяют в стакане с теплой водой. В раствор погружают палец и держат в течение четверти часа. Затем на поверхность наносят Перекись водорода. Процедуру проводят ежедневно до тех пор, пока симптомы ушиба не исчезнут;
- рецепт №3: лист подорожника промывают под проточной водой, наносят на его поверхность тонкий слой меда, прикладывают к поврежденному ногтю и фиксируют повязкой. Компресс оставляют на ночь;
- рецепт №4: порошок Бадяги разводят теплой водой и наносят на поврежденный участок. Смывают средство через два часа теплой водой. Процедуру проводят при отсутствии повреждений кожного покрова дважды в день до облегчения симптомов;
- рецепт №5: траву полыни горькой мелко нарезают, прикладывают к ушибу, сверху накрывают полиэтиленом и фиксируют повязкой. Снимают компресс через три часа. Процедуру повторяют каждый день, пока боль не отступит.
Восстановительный период
В течение всего периода реабилитации необходимо избегать физических нагрузок на травмированную руку.
Срок нетрудоспособность после травмы составляет от 1 до 3 недель. При подкожном разрыве сухожилия, переломах и трещинах кости он увеличивается до одного месяца.
В случаях, когда по истечению этого периода травмированный палец не разгибается, может потребоваться хирургическое вмешательство.
Если в течение недели после травмы состояние пациента не улучшается, боль усиливается или появляются гнойные выделения, необходимо обратиться за повторной консультацией к травматологу или хирургу, чтобы исключить развитие осложнений.
Видео
Предлагаем к просмотру видеоролик по теме статьи.
По статистике пальцы на руках и ногах относятся к самым уязвимым частям тела и ушиб ногтя можно получить при сильном ударе конечности о выступ, попадании тяжелого предмета на ногтевую фалангу, защемлении пальца. Особенно часто страдают от ушиба большие пальцы ног, так как ступней можно легко зацепить случайный выступ или увесистый объект во время ходьбы. После травмы фалангу пальца пронизывает резкая пульсирующая боль, которая активно нарастает и постепенно утихает. Но через некоторое время ногтевое ложе большого пальца темнеет, ушибленный ноготь может постепенно отойти от мягких тканей и во время ношения обуви пострадавший испытывает сильный дискомфорт.
Сильный ушиб ногтя на пальце руки или ноги обычно сопровождается обширным кровоизлиянием в мягких тканях ногтевого ложа с последующим появлением хорошо заметной гематомы под пластиной. После травмы на ногтевой фаланге пальца образуется отек, гематома под ногтем может посинеть и даже почернеть от свернувшейся крови в подкожно-жировой клетчатке с кровоподтеком. Ушибленный ноготь на ноге теряет блеск, желтеет и в некоторых случаях происходит отслоение пластины от ногтевого ложа пальца. Чтобы избежать отторжения поврежденного ногтя от ложа и предотвратить проникновение инфекции в мягкие ткани пальца с последующим нагноением под ногтевой пластиной, важно как можно скорее начать лечение ушиба. Из этого материала вы узнаете, что нужно делать в первую очередь после получения травмы ногтевой фаланги и как организовать лечение ушибленного пальца в домашних условиях.
♦ ЧТО ДЕЛАТЬ С УШИБЛЕННЫМ НОГТЕМ НА НОГЕ
❶ Первая помощь.
• Чтобы снять острую боль и предотвратить отек пальца, снимите обувь и приложите к ногтевой фаланге ноги холодный предмет или же подержите палец в холодной воде. Идеально, если есть возможность сразу же сделать компресс из марли (или любой ткани) со льдом. При сильной пульсирующей боли в пальце можно принять анальгетик.
• Нередко после ушиба ногтевой фаланги большого пальца ноги жесткая пластина травмирует боковые валики или же треснувший ноготь вонзается в мягкие ткани ложа. В этом случае важно как можно скорее обработать поврежденные ткани пальца антисептиком, любым противомикробным средством, которое есть под рукой: спиртосодержащая жидкость, раствор йода, зеленка, перекись водорода. Если неприятность случилась во время отдыха на природе, поищите рядом с дорогой подорожник, разомните лист и приложите к открытой травме.
❷ Устранение гематомы под ногтем.
Если случилось кровоизлияние в подкожную жировую клетчатку ногтевого ложа, опухший палец под ногтем посинел, то обязательно обратитесь за помощью к хирургу. Врач осмотрит палец и при необходимости удалит скопившуюся кровь под ногтевой пластиной, сделав на ней небольшой надрез. После процедуры врач обработает палец антисептиком и сделает антибактериальную повязку.
❸ Гепариновая мазь.
Популярное средство наружного применения для обработки мягких тканей после ушибов. Гепариновая мазь восстанавливает нормальную микроциркуляцию крови в ногтевом ложе, устраняет гематому, снимает отек с пальца. Обработайте мазью ушибленный ноготь и кожу вокруг него, приложите кусочек сложенной марли и зафиксируйте лейкопластырем. Повторять процедуру 2-3 раза в день.
❹ Компресс из уксуса и вина.
Соедините в пиале по 2 столовые ложки сухого вина и яблочного уксуса, добавьте 1 чайную ложку морской соли и хорошенько перемешайте компоненты. Пропитываем ватный диск приготовленной смесью и прикладываем к ногтю на ноге, а затем фиксируем бинтом на пальце. Делать компресс 1 раз в день, через 2 часа повязку снимать.
❺ Солевые ванночки.
Это народное средство особенно популярно для предотвращения заражения мягких тканей, травмированных ногтевой пластиной во время ушиба большого пальца на ноге. Наполняем ванночку теплой водой (2 л.), добавляем в воду 1 столовую ложку морской соли, 1 столовую ложку пищевой соды, 1 чайную ложку йода. Всё перемешать и поместить в раствор ноги. Через 15 минут насухо обтереть ноги и обработать травмированный палец перекисью водорода. После распаривания ног можно нанести лечебную мазь на кожу вокруг ногтя.
— на фото: ногти на ногах после ушиба
♦ ЧТО ДЕЛАТЬ С УШИБЛЕННЫМ НОГТЕМ НА РУКЕ
❶ Первая помощь.
• Сразу после ушиба опустите палец в холодную воду на 5 минут, чтобы снять болевые ощущения, предотвратить появление отека и сильное кровоизлияние под ногтем
• Обработайте ногтевую фалангу антисептиком и примите анальгетик, если пульсирующие боли в пальце продолжаются. Если вокруг ногтя имеются открытые раны после травмы, то обработайте их перекисью водорода, а затем — зеленкой или раствором йода.
❷ Эмульсия Рициниол.
Эмульсия сделана на основе касторового масла и обладает, обезболивающими, противовоспалительными и ранозаживляющими свойствами. Обрабатывайте ушиб ногтевой фаланги пальца 2-3 раза в день, чтобы скорее избавиться от гематомы, устранить отечность и предотвратить нагноение рядом с ногтем.
❸ Противовоспалительный компресс.
Средство помогает очень быстро восстановить структуру поврежденных мягких тканей вокруг ногтя на руке, ускорить заживление травмы и рассасывание гематомы, предотвратить развитие абсцесса. Соедините в пропорции 1:3 раствор димексида с раствором новокаина 0,25%. Пропитываем этой смесью марлевый тампон и закрепляем его на фаланге пальца стерильным бинтом. Процедуру можно выполнять перед сном, а снимать повязку на утро.
❹ Домашняя мазь.
Гематома может посинеть или почернеть под ногтевой пластиной от запекшейся крови после кровоизлияния в мягких тканях ложа. Чтобы гематома быстрее рассасывалась, сделайте домашнюю мазь: на мелкой терке измельчите небольшой кусочек хозяйственного мыла 72% (примерно 40 гр.), добавьте 200 мл скипидара, 50 мл лампадного масла (можно заменить камфорным маслом). Все компоненты тщательно перемешать и наносить мазь 3-4 раза в день на ушибленный палец в течение недели.
❺ Маска из бадяги.
Средство помогает устранить отек пальца после ушиба, стимулирует регенерацию поврежденных тканей, помогает избавиться от гематомы под ногтем на руке. В 100 мл теплой воды размешиваем 30 гр. аптечного порошка бадяги. Эту маску наносим на ногтевую фалангу и ждем, пока средство не подсохнет. Делать маску 2 раза в день до полного восстановления мягких тканей пальца после ушиба.
— на фото: ногти на руках после ушиба
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