Unicycling Injuries: how to drain a subungual haematoma

I’m going to do a few articles on unicycling injuries, but I thought I would I would start with a subungual haematoma, after sustaining one at yesterdays Karapoti Classic mountainbike race.

Here is the article I made on draining a subungual haematoma using the paper clip method:
http://www.adventureunicyclist.com/2013/03/02/unicycling-injuries-how-to-drain-a-subungual-haematoma/

And the how-to-do video

You sick F***!

very good, i love write ups like that

Wait til he does the one on setting a compound fracture while sitting in the middle of the road. If I were you I would avoid watching the associated video. :sunglasses:

I had always considered the toenail dead when it looked like that. Just poked a needle under it if the pressure was too uncomfortable to drain it.

Thanks for an instructive video.

I think I’ll skip lunch for all that…

But of course, how did you get on at the Karapoti this year? Looking forward to hearing about it.

My toe feels so much better already.

Anyway, the video doesn’t show it very well, but you can see it better on these close ups. Notice how the colour comes back to the toe once the haematoma is evacuated.

This will still work a few days later. For some reason blood doesn’t seem to clot under the nail- I’ve drained these things three or four days after the injury and the blood still seems liquid.

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Yeah, I remember that (via these fora), but I can’t even imagine. Takes “gnarly” to a whole new level.

I used to file my second toenails off to avoid this

from running. It’s easier to run less and muni and skate more.

Usually, I drain ‘Subungal haemotomas’ (woohoo! new medical term) by drilling through them with a pin vice and a teeny tiny drill bit. Make sure you do it when your nail’s hard (not after a bath) otherwise it won’t drill properly - it’ll ‘corkscrew’ in and hurt like hell.

Drilling down works too, but we normally use 21Ga needles at work, because no one ever seems to have a candle or a paperclip. Just very gentle pressure and patience required. The holes don’t come out quite as big as a red-hot paperclip, so you have to drill quite a few holes to evacuate the haematoma.

You could try a soldering iron too.

The trick is not to put too much pressure down- you’ll pop through the nail and the blood will come out long before you hit your toe with a red hot paperclip or a needle.

Hematomas are bad enough, but I’d be worried about trying to drain one as doing so could cause part(s) of the clot to break away and travel to vital organs ans lodge! Last thing you want is a PE! :astonished:

Thanks! Great video! How about tips on deep saddle sores (maybe not a video)?

The clot is outside underneath your toenail, not sitting in a vein :slight_smile:

I plan to do more of these when I get time. I guess on some other common injuries like cuts and sprains.

If I ever get a deep enough cut, I’ll do a video of stitching myself up.

Saddle sores- hmmm…haven’t thought about that. Not sure there is much treatment apart from staying off the Uni.

for saddle sores butt paste is the shit

Thanks for the tip. I have them under control now (using benzoyl peroxide) but there’s one around the bike shorts cuff line that’s really deep and I’m thinking I’ll have to go to the doctor to check it out.

I am riding with compression short now that have only 2 seams :smiley: