Nail Bed Avulsions
Other Names
- Avulsion of nail bed
Background
- Avulsion of the nail and a portion of the underlying nail bed
Pathophysiology
- Anatomy: Nail Bed Anatomy
- Typically involves a high energy injury
Risk Factors
- Unknown
Differential Diagnosis
- Fractures
- Dislocations
- Tendinopathies
- Extensor Tendon Injuries of the Hand
- Central Slip Extensor Tendon Injury
- Flexor Tendon Injuries of the Hand
- Boutonniere Deformity
- Swan Neck Deformity
- Jersey Finger
- Mallet Finger
- Trigger Finger
- De Quervains Tenosynovitis
- Volar Plate Avulsion Injury
- Sagittal Band Injury
- Mannerfelt Lesion (FPL Rupture)
- Ligament Injuries
- Neuropathies
- Arthropathies
- Nail Bed Injuries
- Pediatric Considerations
- Other
Clinical Features
- General: Physical Examination Hand
- The patient will present with loss of nail
- Typically bleeding from affected area
Evaluation
- 3 view radiograph to identify if fracture present
Classification
- N/A
Management
Nonoperative
- Give tetanus, antibiotics
- Typically a surgical problem
- Procedure: Nail Bed Repair
Operative
- Almost universally a surgical problem
- Involves:
- Nail Removal
- Nail bed repair
- Fracture fixation (+/-)
- Potentially, graft or matrix transfer
Return to Play
- Surgeon discretion
- Needs to be updated
Complications
- Distal Phalanx Fracture
- Hook Nail
- Split Nail
See Also
External
- Sports Med Review Hand Pain: https://www.sportsmedreview.com/by-joint/hand/