NAIL BED INJURIES

Injuries to the nail are often associated with damage to other structures that are in the same location. These include fractures of the bone (distal phalanx), and/or cuts of the nailbed, fingertip skin (pulp), tendons that straighten or bend the fingertip, and nerve endings.

What causes nail bed injuries? Many result from crush injuries after getting the fingertip caught in a door. Any type of pinching, crushing, or sharp cut to the fingertip may result in injury to the nail bed.

Treatment of nail bed injuries Restoring the normal anatomy of the nail and surrounding structures is the goal of treatment. Simple hematomas are drained by making a small hole in the nail in order to relieve the pressure and provide pain relief. Straightforward cuts are repaired to put the parts back where they belong.Repairing the nail bed to which the fragments of bone are attached usually restores alignment of many fractures of the fingertip. Larger fragments of bone may need to be pinned or require splinting to heal the fracture. Missing areas of nail bed can be grafted from the same finger or from other digits. Tendon injury may require splinting or pinning. Local flaps of skin may be used to replace missing skin, or the open area of skin may be allowed to just heal on its own, or covered with a skin graft.