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Pilot Feasibility Stud 2015 19;1:29. Epub 2015 Aug 19.

Guy's and St Thomas' Hospitals NHS Trust, London, UK.

Background: Nail bed injuries account for the majority of paediatric hand trauma cases. Despite their frequency, controversy remains regarding their treatment. The accepted teaching is to remove the fingernail, repair the underlying nail bed with fine sutures and replace the nail under the nail fold. Read More

Pediatr Emerg Care 2014 Oct;30(10):742-5; quiz 746-8

Pediatric Emergency Medicine Attending, Assistant Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Mercy Hospital & Clinics, University of Missouri-Kansas City, Kansas City, MO.

Fingertip crush injuries are common hand injuries in children and often are evaluated initially in an emergency department. Nail bed injuries can be classified into subungual hematomas, simple or stellate lacerations, crush injuries, and avulsions. Emergency department physicians with good knowledge of fingertip anatomy can appropriately manage these injuries so as to prevent long-term fingertip deformities and functional deficits. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014 Jul;28(7):862-4

Objective: To explore the effectiveness of the side island flap coinciding dorsal branch of the digital. nerve for repairing thumb pulp defects.

Methods: Between May 2008 and July 2012, 36 cases of thumb pulp defects were treated with the side island flap coinciding dorsal branch of the digital nerve. Read More

J Craniofac Surg 2009 Jul;20(4):1033-5

Department of Orthopaedic and Plastic Surgery, University of Miami, Miami, FL, USA.

Crush injuries of the fingertip are the most common hand injuries seen in children. Many involve fracture of the distal phalanx, whereas others result in either crush alone or complete or partial fingertip amputation. The need for nail removal and nail bed repair after crush injury to the fingertip has long been a matter of debate. Read More

J Hand Surg Am 2008 Feb;33(2):250-3

Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases, New York, NY 10016, USA.

Purpose: To prospectively compare the efficacy of 2-octylcyanoacrylate (Dermabond; Ethicon Inc, Somerville, NJ) with standard suture repair in the management of nail bed lacerations.

Methods: Forty consecutive patients with acute nail bed lacerations were enrolled in this study. Eighteen patients were randomized to nail bed repair using Dermabond (2-octylcyanoacrylate), and 22 were randomized to standard repair using 6-0 chromic suture. Read More

J Hand Surg Eur Vol 2007 Dec 17;32(6):668-74. Epub 2007 Aug 17.

Patankar's Hand & Limb Reconstruction Clinic, Chembur, Mumbai, Maharashtra, India.

A series of 66 patients, aged between 1 and 70 years, with 70 disruptive injuries to finger nails was reviewed. The injuries were treated by cleaning of the finger, evacuation of haematoma and anatomical replacement of the nail plate, or a substitute, which was secured with a modified dorsal tension band suture without formal repair of the nail bed. K-wire fixation of the distal phalanx was employed only in the event of displaced fracture of the distal phalanx, complete absence of the nail plate and laceration extending to the distal pulp. Read More

J Hand Surg Br 2004 Dec;29(6):634-5

The Hand Unit, Nuffield Orthopaedic Centre, Oxford, Headington, UK.

Fingertip injuries are common and are often repaired. The nail plate is replaced to protect the repair and maintain the alignment of the nail bed edges after repair. Once replaced, this can be secured by any means and often a suture is used. Read More

J Hand Surg Am 1999 Nov;24(6):1166-70

Department of Orthopaedic Surgery, University of Arkansas for Medical Science, Little Rock 72205, USA.

Fifty-three fingers in 52 children were divided into 2 groups, operative and nonoperative, after fingernail crush injury. Criteria for inclusion into the study were an intact nail and nail margin with subungual hematoma and no previous nail abnormality. The length of the follow-up period averaged longer than 2 years for each group. Read More

Ann Plast Surg 1998 Oct;41(4):390-6

Division of Plastic Surgery, University of Illinois at Chicago and Cook County Hospital, 60612-7316, USA.

A retrospective review of 22 patients who sustained snowblower injuries to the hand was performed. There were 17 men and 5 women, ranging in age from 20 to 68 years (average age, 39.7 years). Read More

Am J Emerg Med 1987 Jul;5(4):302-4

Subungual hematomas are one of the most common injuries involving the hand. On conducting a literature search, we were unable to find any studies that investigated the association between subungual hematomas, fractures, and the presence of an occult laceration of the nail bed requiring repair. Forty-seven consecutive patients who presented to the emergency department with subungual hematoma involving more than one fourth of the nail bed were included in this study. Read More