Injuries to the fingernails are usually traumatic and acute. They often occur from crush injuries or deep lacerations through the top of the finger. Often these type of injuries not only involve the fingernail but the surrounding structures as well. Fractures, amputations, nerve and tendon damage may also be seen in association with fingernail trauma.
The fingernail (nail plate) sits on top of and protects the nail bed. In some instances, such as in the case of a subungual haematoma (blood under the fingernail), the nail plate will need to be removed to repair the nail bed and to drain the haematoma. Other minor procedures to repair and restore nail stability can range from a wedge excision of the eponychial fold (fingernail groove) to a debridement and washout of the nail bed to remove any infected or unhealthy tissue. Again these procedures are usually following a traumatic incident such as slamming your finger in a car door.
In more traumatic injuries such as in a subtotal or total amputation due to major crush injuries the fingertip pulp and the bone may also need repairing. In some instances the fingertip cannot be repaired to its original state and skin flaps may need to be performed for reconstruction.
Following repair of any fingernail injury hand therapy will commence to assist with range of motion to prevent joint stiffness and treatment to assist with desensitising the finger tip or repaired defect. After consultation and assessment with Dr Mackay a personalised treatment program will be initiated and implemented.