Nail bed injuries

The nail is an important component of the finger tip. It acts to help the finger for pinching and gives the appearance to the finger. Nail bed injuries are common in children as well as people whose work involves handling machines. Children usually sustain crush injuries from doors while adults often sustain it from machinery and heavy equipments.

“Sub” means under, “ungual” means nail and “hematoma” means collection of blood. A subungual haematoma forms when blood collects between the nail and nail bed. The formation of a subungual haematoma is often related to heavy impact such as a door crush injury or a heavy weight falling on the finger.

Compression of the nail bed between the distal phalanx and nail can result in a simple or complex laceration. Sharp objects like knives can penetrate the nail if they land with sufficient force resulting in a nail bed laceration.

A nail bed avulsion is when the nail and part of the nail bed are pulled away from the rest of the finger. This is usually caused by higher energy injuries with traction and crushing forces. They are often associated with other injuries, such as distal phalanx fractures and dislocations.

Patients with nail bed injuries will present with pain following an episode of trauma. There may be associated wounds around the finger tip or fracture to the bone.

Your doctor will take an x-ray of your finger to rule out fractures , dislocations and foreign bodies.

The management of nail bed injuries will depend on the type and extent of injury sustained. Simple nail bed injuries may be managed conservatively, often with a short course of prophylactic oral antibiotics. Most nail bed injuries will require removal of the nail plate, nail bed repair, and splinting of the finger tip.

With appropriate treatment, many injuries to the nail bed make a full recovery although it can take months for the nail to grow back normally. Common complications of nail bed injuries include scarring, infection, hook nail and split nail.