eMedicine Specialties > Emergency Medicine > Trauma & Orthopedics

Fingertip Injuries: Follow-up

Author: Glen Vaughn, MD, Director, Department of Emergency Medicine, Defiance Hospital
Contributor Information and Disclosures

Updated: Oct 6, 2009

Follow-up

Further Inpatient Care

  • Keep hand elevated.

Further Outpatient Care

  • Keep hand elevated.
  • Check wound 2 days after ED treatment.
  • Analgesics may be necessary for first few days.
  • Splint fractures in extension for 2 weeks.

Complications

  • Untreated nailbed lacerations may lead to subsequent nail deformities.
  • When amputation with loss of two thirds of the nail occurs, half of the fingers develop beaking or a curved nail.

Prognosis

  • Oldest recorded patient to show fingertip regeneration was aged 11 years.

Patient Education

Miscellaneous

Special Concerns

  • In 60% of patients with subungual hematomas that involve more than 50% of the nail surface, laceration is repairable. This figure increases to more than 95% when an associated fracture of the distal phalanx is present.
  • Conservative treatment without nail removal is advocated for patients with closed hematomas (regardless of the size of hematoma) and intact nails with no skin-fold laceration or nail disruption.
  • The nail complex requires intact distal bone and soft tissue support to prevent a hook-nail deformity.
  • Because of its flammability, do not use ethyl chloride for anesthesia before trephinating a subungual hematoma with cautery. Be careful with artificial nails as well.
 


More on Fingertip Injuries

Overview: Fingertip Injuries
Differential Diagnoses & Workup: Fingertip Injuries
Treatment & Medication: Fingertip Injuries
Follow-up: Fingertip Injuries
Multimedia: Fingertip Injuries
References
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References

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Further Reading

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Keywords

fingertip injury, fingertip injuries, finger tip injury, blunt injuries, crush injuries, subungual hematomas, nail root avulsions, fractures of the terminal phalanx, sharp injuries, shearing injuries, fingertip lacerations, avulsed fingertip, fingertip burns, fingertip frostbite, terminal phalanx, hand injuries, damage to the nailbed, fingertip amputations, nailbed laceration

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Contributor Information and Disclosures

Author

Glen Vaughn, MD, Director, Department of Emergency Medicine, Defiance Hospital
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey Glenn Bowman, MD, MS, Consulting Staff, Highfield MRI, Columbus, Ohio
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eric L Legome, MD, Chair, Department of Emergency Medicine, St Vincent's Hospital Manhattan; Associate Professor, Department of Emergency Medicine, New York Medical College
Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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