The greatest majority of all injuries are to the person’s hand. Our hands get cut, bruised, broken, and sprained. They feel numb, tingly, drop objects, and wake us up from sleep. The largest number of hand injuries affects the fingertips. Fingertips are generally the first point of contact with any potentially dangerous object.
The patient in the example below cut his fingertip on a fan blade. He went to an emergency room and his injury was evaluated and referred to Dr. Yevgeny Shuhatovich immediately at the ROC. After evaluating this injury, the patient was emergently taken to an operating room for all the appropriate repairs.
Fingertip injuries are the most common maladies affecting the person’s hand. The fingertip has several parts to it which can be divided into parts.
- Nail plate is the substance of the nail and frequently gets crushed or simply ripped out.
- Nail bed is the soft tissue underneath the person’s nail and gets cut by the injury.
- Nail folds are soft tissues surrounding the nail and those also get cut or avulsed.
- Bone gets broken by the crushing and deep lacerating injuries.
- Tendons that are right under the skin and if they get cut the finger loses necessary motion.
- Nerves provide feeling to the fingertip and they get cut or crushed.
- Blood Vessels also get cut or crushed and they carry blood to the tissues of the fingertip making it stay alive.
While these are some of the most basic injuries, multiple complicating injuries exist, significantly affecting the treatment. For example, an infection can present after a nail bed injury, requiring an emergency surgery.
The most common reason to perform emergency fingertip surgery is in the presence of an open fracture. An open fracture means that the bone is broken and there is an overlying cut to the skin or soft tissues. Such an injury should be addressed immediately. While the bone does not always need to be fixed, cleaning the injury properly and in a timely fashion is of paramount importance.
Despite popular belief that any healthcare provide can provide appropriate treatment to these injuries, that could not be farther from the truth. There is a lot of research that carefully guides a hand surgeon, when addressing fingertip injuries. Without that knowledge, these injuries can be a devastating, life changing event to the patient. If not treated correctly, fingertip injuries can result in amputations, infection, and constant and unrelenting fingertip pain among many other problems.
Below is an example of an injury that included the nail bed, nail, bone and the nail folds. The very small sutures hold the nail bed together; the slightly larger sutures hold the skin together. The two wires hold pieces of bone together in an appropriate alignment.