Fingertip Injuries and Nail Injuries

Dr. Steven Rueda is one of the most sought after doctors for fingertip injuries and nailbed injuries in Palm Beach. Healthy fingertips are vital for dexterity and sensation of the fingers. The fingertip has many structures on it including skin, nail, tendons, bone, arteries, and nerves. Injury to the fingertip can harm any of the previously mentioned structures and needs diligent repair to recover function.

Fingertip Injuries and Nail Injuries Symptoms and Diagnosis

The symptoms arising from fingertip and nail injuries reflect the traumatic damage to their structures. Some of the most common symptoms include:

  • Loss of the nail
  • Loss or damage to the nail bed
  • Loss of fingertip skin
  • Pain at the fingertip
  • Raw wound at the fingertip

In some cases patients present with all of the symptoms, and in some cases only with some of them.

The diagnosis is made using a combination of history and physical examination. An xray is typically needed to assess the integrity of the bone.

WHAT CAUSES Fingertip Injuries and Nail Injuries?

Fingertip injuries are usually the result of trauma. Most of this trauma happens because the fingertip is vulnerable and due to its small size gets trapped in between doors, closures, windows, and power tools. In rare cases fingertip injuries are a result of surgery to remove cancer or masses.

Fingertip Injuries and Nail Injuries Treatment Options

Treatment for fingertip injuries is dependent on the structures that were injured. The goal of treatment is to preserve the function of the fingertip, sensation, and nail appearance. In case there is a wound with loss of skin, reconstruction of the fingertip using tissue from other body areas may be needed.
Nail injury treatment usually begins by examining the integrity of the nail bed, the structure that gives rise and holds the hard nail in position. If the nail bed is cut or injured, it may require removal of the hard nail to repair the underlying nail bed with sutures or grafts. All of this in order to restore nail growth and appearance. Injured nail bed may give rise to split or indented nails even after repair.

Damage to the skin and soft tissue in the fingertip may be anywhere from a cut to complete loss of the skin covering the fingertip. In most cases dressing changes for several weeks allow the body to regrow the skin over this area; this is only possible if there is no exposed bone. For those with exposed bone or those who need earlier recovery, skin from other areas of the body is borrowed to replace the missing skin. This is done in the form of skin grafts or skin flaps.
Bony injury usually is well treated with no additional intervention after all the soft tissue and nail tissue has been repaired. In some limited cases placement of a pin to hold the bone in place is necessary. In severe injuries with substantial crush and tissue loss, amputation may be needed. Fortunately, the amputation is only at the site of injury and not of the entire finger. The loss of function from amputation is minimal and most patients can use their hands very well.

Fingertip Injuries and Nail Injuries Procedure

Procedures for fingertip reconstruction are very variable and depend on the areas injured (nail, tendons, bone, etc.) and the tissue available to rebuild a new finger. The treatment options are more complex and include closures with sutures, bone debridement, use of grafts to rebuild the nailbed, tendon repairs, and flaps to rebuild the padding of the fingertip. In most cases patients, specially for those who have no nail or bone injury, performing simple dressing changes allows the fingertip to heal on its own in 2-6 weeks. Dr. Rueda prefers to discuss treatment options including incisions, location, and types of repair during the office visit.

RECOVERY AND DOWNTIME

Recovery from fingertip injuries can be lengthy if there is large skin loss and is being treated with dressing changes. On average the recovery is 2-3 weeks, but can extend up to 6 weeks. There is decreased sensation on the fingertip for several months, and it can take up to a year for sensation to return. There is a chance the sensation does not return back to normal but is always somewhat decreased compared to the other uninjured fingers. The shape of the fingertip may also be somewhat different and appear more lumpy, chubby, or skinny. The nail may appear smaller and shorter, and in some cases may grow with grooving or splits.

Downtime from a fingertip injury can be anywhere from 1-8 weeks depending on the injury and procedure. Most patients can return to work in 2 weeks if they can keep the wound clean and labor in fields that do not require handling of food or health conditions.

Why Choose Precision Hand Center for your Fingertip Injuries and Nail Injuries Procedure?

Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for fingertip injuries and nail injuries. Successful results in this procedure requires a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in expert peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best fingertip injury and nail injury treatment Palm Beach can offer.

FREQUENTLY ASKED QUESTIONS (FAQ)

For injuries that were sharp and had small or no tissue loss, the fingertip can look the same as before the injury. When the injury results from crush or has substantial tissue injury the fingertip will not look the same as before. However, most patients are pleased to have been able to retain their finger and not require an amputation.

Yes! These procedures are done usually 6-12 months after the injury and attempt to remove the scar tissue that leads the nail to split. Nail grooves are more difficult to correct and the options are limited.