Abstract
Fingertip and nail bed injuries are the most common injuries of the hand. Large subungual hematomas should be drained to relieve pressure and pain; small and asymptomatic hematomas (<50%) can be observed; trephination of a subungual hematoma is performed to relieve the throbbing pain associated with this injury. When the nail plate is intact, not all nail bed lacerations need to be repaired. Common secondary nail deformities seen after nail bed injury include nail ridging, splitting, nonadherence, absence, cornified nail bed, hook nails and spikes, or nail cysts. Knowledge of the anatomic arterial branching patterns of the fingertip allows creation of flaps to preserve length after distal fingertip amputation injuries, including the volar and lateral V–Y advancement flaps. In the appropriate patient, subungual melanoma in situ can be safely treated without amputation.
Published Version
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