Nail Bed (Nailbed) Injury Management in the ED Workup

Updated: Dec 27, 2021
  • Author: Darrell Sutijono, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Imaging Studies

Depending on the extent of injury, radiologic evaluation with anteroposterior, lateral, and oblique views of the injured finger(s) may be useful to rule out foreign bodies and fractures or dislocations of the distal finger. [6]

In a study of children with nail bed (nailbed) injuries, the authors found that 50% of their patients had an associated distal phalangeal fracture, most often a comminuted tuft fracture. [16] Most tuft fractures, in the setting of a nail bed injury, require no specific treatment outside of addressing the nail bed injury and protective splinting. Transverse shaft fractures that are significantly displaced may require surgical repair. [17]

In a study utilizing point-of-care ultrasound in patients presenting to the ED with distal finger trauma, sensitivity was 93.4% and specificity was 100% for diagnosing nail bed injury. [18]