Case report of nail bed injury after blunt trauma; what lies beneath the nail?
BACKGROUND
A stable, mobile and sensate fingertip is of paramount importance to perform daily tasks and sense dangerous situations. Unfortunately, fingertips are easily injured with various extents of soft tissue damage. Delayed and inadequate treatment of nail bed injuries may cause substantial clinical problems. The aim is to increase awareness about nail bed injuries among physicians who often treat these patients.


METHODS
We present a 26-year-old male with blunt trauma to a distal phalanx. Conventional radiographs showed an intra-articular, multi-fragmentary fracture of the distal phalanx. At the outpatient department the nail was removed and revealed a lacerated nail bed, more than was anticipated upon during the first encounter at the emergency department.


CONCLUSIONS
Blunt trauma to the fingertip occurs frequently and nail bed injuries are easy to underestimate. An adequate emergency treatment of nail bed injuries is needed to prevent secondary deformities and thereby reduce the risk of secondary reconstruction of the nail bed, which often gives unpredictable results.


CONCLUSIONS
However, adequate initial assessment and treatment are important to achieve the functional and cosmetic outcomes. Therefore awareness of physicians at the emergency department is essential.
Department of Surgery, Reinier de Graaf Groep, Delft, The Netherlands. Electronic address: geraldinenanninga@gmail.com.
Geraldine L
GL
Nanninga
Department of Surgery, Reinier de Graaf Groep, Delft, The Netherlands.
Kevin
K
de Leur
Department of Surgery, Reinier de Graaf Groep, Delft, The Netherlands.
Anne Loes
AL
van den Boom
Department of Surgery, Reinier de Graaf Groep, Delft, The Netherlands.
Mark R
MR
de Vries
Department of Surgery, Reinier de Graaf Groep, Delft, The Netherlands.
Tessa M
TM
van Ginhoven
Blunt trauma; Distal Phalanx; Fingertip injuries; Nail bed