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Nail Injuries (cont.)

Nail Injury Prevention

Although most nail injuries are accidents, some precautions can be taken to reduce the chances of this happening.

  • Keep nails trimmed short to keep them from snagging on objects.
  • Always keep the supporting hand out of the potential path of a box cutter or other sharp object.
  • Be careful around machinery or when using hammers.
  • Use door guards to prevent children from accidentally closing doors on their fingers.

Nail Injury Prognosis (Outlook)

Even with proper wound care, a permanent deformity of the nail is common. The nail will grow back, but it may have a groove or dent in it.

  • If part of the fleshy part of the finger was lost, a hook nail may result. This occurs when the nail grows in a hook over the end of the finger or toe. This can sometimes be corrected later with plastic surgery.
  • If the nail was removed, or if there is a large nail bruise, then the injured nail will probably fall off as a new nail grows back. It will take four to six months for a new fingernail to grow back, and 12 months for a new toenail.
  • Infection can occur. This is more common with bite injuries or contaminated wounds. Infection is also a risk for people with diabetes or AIDS, those undergoing chemotherapy, those with poor circulation due to any reason, or those who have other problems that may decrease the ability to fight infection.

Nail Injury Picture

Anatomy of the fingernail. Top: the normal fingernail. Bottom: nail bed laceration with subungual hematoma.
Anatomy of the fingernail. Top: the normal fingernail. Bottom: nail bed laceration with subungual hematoma.

Medically reviewed by Norman Levine, MD; American Board of Dermatology

REFERENCES:

Adani R, Marcoccio I, Tarallo L. Plast Reconstr Surg. 2003 Oct;112(5):1287-94. Nail lengthening and fingertip amputations.
Boyd R, Libetta C. Emerg Med J. 2002 Mar;19(2):141. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Reimplantation of the nail root in fingertip crush injuries in children.
Bristol SG, Verchere CG. J Hand Surg [Am]. 2007 Jan;32(1):124-5. The transverse figure-of-eight suture for securing the nail.
Brown RE. Hand Clin. 2002 Nov;18(4):561-75. Acute nail bed injuries.
Chang J, Vernadakis AJ, McClellan WT.Clin Occup Environ Med. 2006;5(2):413-22, ix. Fingertip injuries.
Evans DM, Bernardis C. J Hand Surg [Br]. 2000 Feb;25(1):58-60. Erratum in: J Hand Surg [Br] 2000 Aug;25(4):414. Bernadis, C [corrected to Bernardis, C]. A new classification for fingertip injuries.
Hallock GG, Lutz DA. J Hand Surg [Am]. 2000 Sep;25(5):979-81. Octyl-2-Cyanoacrylate adhesive for rapid nail plate restoration.
Jellinek NJ. Dermatol Ther. 2007 Jan-Feb;20(1):68-74. Nail surgery: practical tips and treatment options.
Muneuchi G, Tamai M, Igawa K, Kurokawa M, Igawa HH. Ann Plast Surg. 2005 Jun;54(6):604-9. The PNB classification for treatment of fingertip injuries: the boundary between conservative treatment and surgical treatment.
Roser SE, Gellman H. J Hand Surg [Am]. 1999 Nov;24(6):1166-70. Comparison of nail bed repair versus nail trephination for subungual hematomas in children.
Sawabe K, Suzuki S, Miyata A, Kitayama T, Ishikawa K. Ann Plast Surg. 2005 Jun;54(6):673-5. Application of the palmar pocket method for total nail reconstruction without vascular anastomoses.
Seaberg DC, Angelos WJ, Paris PM. Am J Emerg Med. 1991 May;9(3):209-10. Treatment of subungual hematomas with nail trephination: a prospective study.


Medically Reviewed by a Doctor on 8/14/2015
Medical Author:

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