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10.06 Nailbed Laceration


Presentation

The patient has either cut into his nailbed with a sharp edge or crushed his finger. With shearing forces, the nail may be avulsed from the nailbed to varying degrees and there may be an underlying bony deformity.

What to do:

What not to do:

Discussion:

Significant nailbed injuries can be hidden by hemorrhage and a partially avulsed overlying nail. These injuries must be carefully repaired to help prevent future deformity of the nail. There are no truly non-adherent dressings for a nailbed, so when it is exposed, arrange to change the dressing in 12 to 24 hours before it adheres to this delicate tissue. Surgical consultation should be obtained when complex nailbed lacerations involve the germinal matrix under the base of the nail. Later nail deformity or splitting can sometimes be repaired electively but often it is permanent.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
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