Nailbed & Fingertip Injuries
A fingertip injury refers to any injury involving the nail bed, bone and pulp of your finger or thumb. Occasionally, it may also involve the flexor and extensor tendons. Fingertip injuries commonly occur in accidents at home, work or play, and can involve a sharp cut, crushing or tearing injury.
Because the fingertips are rich with nerves and are extremely sensitive, a fingertip injury without prompt and proper treatment may result in persistent pain, hypersensitivity and numbness. Left untreated, a fingertip injury may also lead to permanent deformity or disability.
The nail bed is the part that is most commonly involved in fingertip injuries. Nail bed injuries typically present as nail bed laceration, loss of tissue and nail avulsion. These require prompt treatment to stop bleeding, prevent infection and nail deformity.
Causes
The fingertip can be traumatised if it is caught between two objects or hit by something heavy, like a door. It can also be damaged by cuts from a knife or a saw. This can result in a fractured fingertip and symptoms include pain, numbness, redness, swelling and bruising.
Diagnosis
Upon sustaining a fractured fingertip injury, symptoms should appear fairly quickly and you should see a doctor immediately who will administer first aid, depending on the circumstances surrounding your injury. It is important to start antibiotics, give a tetanus injection and irrigate or wash out your wound promptly if there is breach of the nailbed or skin to reduce the risk of infection.
Treatment
The main goal of treatment is to have a pain-free fingertip with near normal skin and function, hence your hand surgeon will try as much as possible to preserve the length and appearance of your finger.
There are three main treatment options for nail bed injuries, and these options depend on the initial presentation:
- Subungual hematomas
Subungual hematomas refer to blood clots underneath your nail bed. This kind of injury is usually caused by your nail getting crushed or hit by a heavy object, resulting in throbbing pain and bruising. The hand surgeon will usually drain the blood clot by using a needle to make a small hole in the nail, overall relieving the pain and pressure.
- Nail bed lacerations
Nail bed lacerations refer to the nail, as well as the underlying nail bed getting cut. It is usually caused by a saw, knife or even crushing injury. Patients who have a nail bed laceration will observe bleeding, and are able to see the cut through their nail. In severe cases, there may be loss of nailbed tissue. It is important to have the nail bed laceration properly closed with fine stitches, otherwise nail bed deformity may result. It may be necessary to remove the nail to facilitate a proper repair. But fret not, as the nail will eventually grow back.
- Nail bed avulsion
A nail bed avulsion is when the nail and part of the nail bed is pulled away from the skin of the finger. It usually occurs in people who had their finger stuck or jammed in something. Patients will experience pain and swelling of the finger, with fractures commonly seen with this type of injury.
Treatment option for this injury requires the removal of the nail, and if there is a finger fracture, then splinting or surgery may be necessary.
Every case is different, hence it is best to consult a hand surgeon to determine the treatment method that is most suitable for you. Reach out to us today if you are suffering from any fingertip or nail bed injury, and let us help you.
