Any type of pinching, crushing, or sharp cut to the fingertip may result in injury to the nail bed.
Many result from crush injuries after getting the fingertip caught in a door machine.
How do they present to the hand surgeons?
1. Simple crushes very painful collection of blood (hematoma) under the nail.
2. More severe injuries –cracking of the nail into pieces, or tearing off of pieces of the nail and/or fingertip, and possible injuries to the adjacent structures.
What are the associated problems?
• Finger tip bone fracture- X-rays is recommended to find it.
Treatment of nail bed injuries:
• Straightforward cuts are repaired to put the parts back where they belong.
• Repairing the nail bed to bone fragments restores alignment of many fractures of the fingertip.
• Larger fragments of bone need pin/splinting to heal the fracture.
• Missing areas of nail bed can be grafted from the same finger or from other digits.
Prognosis:
The final appearance and function of the nail and surrounding structures depends on the ability to restore the normal anatomy and it takes 3-6 months for the nail to grow back.
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