Nail and Nail Bed Injuries
By: Corinne Gehegan, DPM
Injuries to the nail may be as simple as a contusion resulting in a
bruise or as extensive as a traumatic avulsion of the nail with a nail
bed laceration. Often times a subungual hematoma (bruise) develops. This
may simply be monitored as the nail grows and the hematoma advances. In
these cases the nail may remain intact or it may fall off on its own. In
some instances a small infection at the junction of the nail and the
skin may evolve because bacteria have the opportunity to enter once this
junction is violated. This is known as a paronychia. Treatment may
include antibiotics, drainage of purulence with or without removing the
entire nail or a portion of it.
If there is extensive pressure and bleeding from underneath the nail, it
is possible that a nail bed laceration was sustained. Treatment may
require removing the nail partially or entirely under local anesthesia,
irrigating the wound, and suturing the defect. Antibiotics may be
prescribed. X-rays may be taken to rule out a fracture of the underlying
bone. A fracture plus a nail bed laceration is considered an open
fracture and is best addressed as soon as possible to avoid bone
infection.
Possible consequences of nail and nail bed injuries are fungal
infections (onychomycosis) and irregular future nail growth due to a
damaged nail root (matrix) at the time of injury. This may only be
evident months after the injury as new nail appears. Prevention and
management of onychomycosis can be discussed with your doctor.
Article written by Dr. Corinne Gehegan
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