Nail Bed Injuries

An important structure of the fingertip is the nail bed and plate. The nail bed is attached to the dorsal (or top part) of the distal phalanx, and from its proximal portion there are specialized cells, which produce the nail plate. The remainder of the nail bed functions to secure the nail plate adherence. Common injuries such as “crush injuries” to the fingertip may cause injury to the underlying nail bed. When there is blood noted underneath the nail plate (subungual hematoma), a significant injury to the underlying nail bed may be present and surgical repair should be considered. For lesser injuries, simple drainage (trephination) of the subungual hematoma may suffice.

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