Nail Avulsions

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May 5, 2011 by dailybolusoflr

Nail Avulsions

 

Fingertip injuries often result in a lost or badly damaged nail.

 

After any injuries to the nail bed are repaired and the nail bed is irrigated or any debris, most authors agree that a barrier should be placed under the eponychium to separate it from the nail bed.  This is to prevent scarring or abnormal connection from forming which would prevent nail from growing out normally from the germinal matrix. 

 

The best barrier to use, if it is present and intact, is the patients’ own nail.  If the nail is not available of usable, you can make a barrier by inserting a piece of the aluminum foil found in a suture or Vaseline gauze pack.  It can be cut to size and inserted under the eponychium.  This will be pushed out as the new nail grows.  New nail can take up to 5 months to grow, as nail will come in about 1mm per week.

 

There has also been publication regarding the use of artificial acrylic nails as well.  I am attaching the link to the reference.

 

http://jhs.sagepub.com/content/35/6/512.full

 

For anatomy of the nail, please see below.

 

http://en.wikipedia.org/wiki/File:Fingernail_label.jpg

 

 

 

 

Linda Regan, MD FACEP

Program Director, Emergency Medicine Residency

Johns Hopkins Medical Institutions

1830 East Monument Street

Suite 6-100

Baltimore, MD 21287

Office: 410-955-5107

Office: 410-614-9823

Fax: 410-502-5146

lregan@jhmi.edu

 

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