Subungual haematoma
Management
- < 50% of nail bed -> Decompress with needle
- > 50% -> remove nail and repair bed
Nail bed lacerations
Options
1. > 50% nail lost
- will get hook nail
- ablate nail bed
2. < 50 % nail lost
- repair bed under magnification
- 6.0 chromic cat gut
- reduce nail plate back into fold to prevent adherence of dorsal and ventral folds
3. Matrix defects
- can place nail bed material in place without sutures
- can use split thickness free nail bed graft
(i.e. from amputated digit)
4. Proximal avulsion of nail plate
- always have germinal matrix laceration
- should always have 3 x horizontal mattress sutures
Complications
Hook Nail
