Fingertip avulsion: Difference between revisions
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* The '''hyponychium''' is the palmar surface skin distal to the nail. | * The '''hyponychium''' is the palmar surface skin distal to the nail. | ||
* The '''lunula''' is that white semi-moon shaped proximal portion of the nail. | * The '''lunula''' is that white semi-moon shaped proximal portion of the nail. | ||
*The '''matrix''' is deep to the nail, adheres to it and is distal to the lunule. | *The '''sterile matrix''' is deep to the nail, adheres to it and is distal to the lunule. | ||
*The '''germinal''' portion is proximal to the matrix and is responsible for nail growth. | *The '''germinal''' portion is proximal to the matrix and is responsible for nail growth. | ||
Revision as of 03:47, 16 December 2013
Background
- Consult hand surgeon for all patients with Amputation proximal to the lunula (crescent-shaped whitish area)
Anatomy
- The perinychium includes the nail, the nailbed, and the surrounding tissue.
- The paronychia is the lateral nail folds
- The hyponychium is the palmar surface skin distal to the nail.
- The lunula is that white semi-moon shaped proximal portion of the nail.
- The sterile matrix is deep to the nail, adheres to it and is distal to the lunule.
- The germinal portion is proximal to the matrix and is responsible for nail growth.
Management
No exposed bone or nail bed involvement
- Treat conservatively with serial dressing changes alone
- Cover wound with nonadherent dressing
- Instruct pt to soak fingertip in antibacterial soap-added water for 10min QD and then rapply nonadherent dressing
- F/u in 2d
Exposed Bone
- Rongeur bone if bony protuberance is <0.5cm in length
- Then let heal by secondary intention as described above
Source
- Tintinalli