Nail Bed Injuries: Treatment & Healing

What are Nail Bed Injuries?

Accidental injuries to the fingertips are quite commonplace due to the basic function and sheer frequency with which we use our hands on a daily basis. Fingertips are extremely vulnerable to tears, lacerations, and crush injuries that result in damage to the nail, skin, tendons, or bone. The subsequent injury can range from simple bruising to fractures, or even tendon and nerve damage. The nerve fibers that provide heightened sensation in the fingertips are the same reason why these injuries can be extremely painful. While a majority of these injuries are not serious they can lead to nail bed deformity without appropriate treatment.

What causes Nail Bed Injuries?

Nail Bed Injuries result from a wide variety of sources usually involving some sort of trauma. A few of the most common causes include the fingertip being crushed between two objects, sliced with a knife or razor, nail avulsion injuries, or being jammed against a hard surface or object.

What are the symptoms of Nail Bed Injuries?

The symptoms of Nail Bed damage are directly correlated with the mechanism and degree of injury. This can include but is not limited to the following:

• Pain
• Swelling
• Dark purple or black bruising to the fingertip or the nail bed known as a subungual hematoma
• Separation of the nail from the nail bed referred to as onycholysis
• Laceration through the nail, cuticle and/or nail bed
• Deep grooves across the nail called Beau’s lines that form months after initial injury
• White spots known as leukonychia that occur after minor injury and disappear over time
• Changes to the texture or shape of the fingernails
• Loss of function or sensation if bone, nerves, or tendons are involved

How are Nail Bed Injuries diagnosed?

An accurate diagnosis can be reached by a simple review of the mechanism of injury and associated symptoms, as well as, a physical examination of the affected digit. X-rays may be indicated if there is suspicion of bone fracture. A treatment regimen can then be put together based on the presenting symptoms.

How are Nail Bed Injuries treated?

Non-surgical

Minor Nail Bed Injuries are often cared for at home. However, it is important to seek medical attention if there are signs of infection or the hematoma covers more than one quarter of the nail bed. Subungual hematomas can be particularly painful but if the injury is recent a physician may be able to drain the blood collection through a small hole created in the nail in a process known as trephining. This painless procedure takes only a few seconds and can release pressure and minimize pain.

Surgical

Major Nail Bed Injuries may require a visit to the Emergency Department or a Specialists Office for a surgical consult once the injury has been stabilized. Nail avulsion injuries will likely require removal of the nail and repair of the nail bed. Finger bones may need fracture fixation or fusion depending on the fracture type. Additionally a tetanus booster and antibiotics are usually recommended for the more serious injuries.

How can Dr. Knight help you with Nail Deformity injuries?

Nail bed injures can be extremely painful, and it is important to have them treated by a professional in a timely fashion. Dr. Knight has seen all kinds of finger injuries in his practice, and is well versed in their treatment. Whatever the need may be, from surgery to the removal of a fingernail, Dr. Knight can do it.

Come visit Dr. Knight, one of the most accomplished hand specialists in Dallas, Texas. See him at the Southlake office or Dallas hand and wrist center.

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HandAndWristInstitute.com does not offer medical advice. The information presented here is offered for informational purposes only. Read Disclaimer

Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.