Abstract:
Background:Management of nail injuries can often be a challenging experience, especially in presence of complex fingertips' injuries that include soft tissue loss and distal phalanx injury. Most studies found in the literature focus on individual injuries and describe methods to tackle those injuries, notwithstanding the fact that the nail, nailbed, distal phalanx, soft tissue and skin of the finger tip form a complex and often more than one element of this complex is injured. This retrospective study therefore focuses on the management of nail bed injuries as a part of the complex finger tip injury and outlines the surgical principles and techniques that were used in their management. Materials and Methods:Two hundred and forty patients from a tertiary care center in different clinical settings where a wide variety of cases involving the nail bed injuries were included in this study. Patients comprised of 192 (80%) males and 48 (20%) females with the average male age of 37.3 years (range 1-66 years) and average female age of 29 years (range 1-59 years). 210 patients had single finger involment, 30 patients had two finger involvement (total fingers involved- 270). The middle finger was most commonly involved while the index finger was the second most commonest finger involved. In 198 (89.18%) patients local anaesthesia was used while in the rest: regional blocks [n = 10 (4.5%)] and general anaesthesia [n = 14 (6.3%)] were used. Results:In this retrospective study, out of the total of two hundred and forty patients, 222 (92.5%) patients underwent surgery, while the rest 18 (7.5%) were treated conservatively. Two hundred and ten patients who underwent surgery had complete healing over the course of treatment and followup, while four patients needed secondary interventional. Eight patients who had surgery were migrant workers were lost to follow up after surgery. Eight patients had postoperative complications that included infection, secondary necrosis, wound breakdown and non healing fractures. Conclusion:Accurate and timely diagnosis of nail bed injury and its meticulous repair is cardinal to the management of any nail bed injury. However all nail bed injuries must be seen in the context of associated injuries of the finger tip complex, namely skin, soft tissue and distal phalanx injuries. Fixation of associated bony injury which closely underlines the nail bed and provides physical support to the nail bed along with correction of soft tissue injuries in the form of flaps or grafts, compounded by the repair or replacement of nail plate in the first 24 hours.
journal_name
Indian J Orthopjournal_title
Indian journal of orthopaedicsauthors
George A,Alexander R,Manju Cdoi
10.4103/ortho.IJOrtho_231_16subject
Has Abstractpub_date
2017-11-01 00:00:00pages
709-713issue
6eissn
0019-5413issn
1998-3727pii
IJOrtho-51-709journal_volume
51pub_type
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journal_title:Indian journal of orthopaedics
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journal_title:Indian journal of orthopaedics
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journal_title:Indian journal of orthopaedics
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doi:10.4103/0019-5413.40251
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doi:10.4103/0019-5413.139835
更新日期:2014-09-01 00:00:00
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pub_type: 杂志文章
doi:10.4103/0019-5413.132525
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/ortho.IJOrtho_430_17
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/0019-5413.33688
更新日期:2007-07-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/ortho.IJOrtho_464_17
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
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journal_title:Indian journal of orthopaedics
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pub_type: 杂志文章
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