The nail is composed of a nail plate, nail matrix and nail bed. The nail bed is the soft tissue that lies below the nail and is essential for the growth of the nail. Nail bed injuries such as crush and avulsion injuries are commonly associated with injuries to the hands or fingertips.
Generally, nail bed injuries are caused from road accidents, sports activities, crush injuries (while handling tools), cutting (while handling machinery) and when the fingers get jammed in doors. The nail bed gets compressed between the hard nail on top and the finger bone below it.
The symptoms of a nail bed injury are based on the type and severity of injury. A minor injury is characterized by swelling and pain. Moderate level of injury may cause collection of blood under the nail (hematoma) with deeper pain. Severe injuries can result in cutting of the nail, tearing and rupturing of adjacent skin and other structures and even fracture of bones under the nail.
When you present to a clinic with a nail bed injury, your doctor performs a thorough physical examination, sometimes under local anesthetic. Your doctor may order X-ray if the nail bed injury is severe and has led to the fracture of a bone.
The goal of treatment is to restore the normal anatomy of the nail bed and the surrounding structures. A simple blood clot which appears as red or purple in color will fade away gradually. Pain killers and antibiotics may be prescribed to alleviate pain and prevent infection. A hematoma can be drained by drilling a hole in the nail. In cases of severe injuries such as a cut nail or broken bones, surgery may be performed to suture the lacerations and align the bones with the help of splinting. Grafts may be used from another finger to replace the injured portion of the nail bed.
Nail bed injuries are mostly accidental. Care should be taken to avoid injury by handling things safely. Some of the precautions which can be taken to avoid the complications of nail bed injury are:
Do not pull off or cut the nail after injury
Apply pressure to stop bleeding
Wash the area carefully and wrap the wound with a clean cloth
North Central Surgical Center Hospital complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. North Central Surgical Center Hospital is a hospital in which physicians have an ownership or investment interest. The list of physician owners or investors is available to you upon request. We are fully licensed by the state of Texas and are Medicare certified. Our facility is also accredited by The Joint Commission. We are an affiliate of United Surgical Partners International, and partnered with local physicians. Physicians are members of the medical staff and are neither employees nor agents of North Central Surgical Center Hospital, United Surgical Partners International, Baylor Scott & White Health, or any of their subsidiaries or affiliates.