About Nail Bed Injury

Fingers which have been crushed or damaged may result in an injury to the nail bed (i.e. closing a car door onto your fingers). With these types of injuries, a patient often presents with bleeding or damage to or under the nail bed. It can also be associated with fractures and other injuries of the hand.

Signs & Symptoms

This may result in an injury to the nail bed (i.e. closing a car door onto your fingers). With these types of injuries, a patient often presents with bleeding or damage to or under the nail bed. It can also be associated with fractures and other injuries of the hand.

The ultimate goal is restoring the anatomy of the fingertip and surrounding structures. Having surgery on your nail bed can prevent nail deformity, reduce infection and reduce the pain experienced.

Treatment Options

What happens during surgery?

The surgery is performed within a surgical theatre. The surgery is generally a day case and you are discharged the same day.

During the surgery the nail will be partially or totally removed. Any damage to the nail bed is repaired and is sutured using dissolvable sutures. A sterile dressing is applied. You may experience some numbness within the area post-surgery due to the anaesthetic but this will eventually wear off.

What happens after surgical repair of a nail bed?

Keep the hand elevated for the 24 – 48hrs after your surgery to reduce swelling. Maintain any pain relief that has been prescribed by the anaesthetist. Any further pain relief medications (other than paracetamol) will need to be prescribed by your GP.

A referral will be given to you at discharge to see a Hand Therapist for a splint, further treatment and dressings of nail bed.

A post-operative appointment is allocated to you at the time of surgical booking, to see A/Prof Matthew Lawson-Smith and the Practice Nurse around the 2 – 3 week mark. At this appointment, A/Prof Matthew Lawson-Smith and the nurse will check on your progress and remove any residual sutures.

It is imperative that you keep the wound dressed, clean and dry until you see A/Prof Matthew Lawson-Smith (unless you are instructed otherwise).

Risks & Concerns

Infection
Scar
Pain
Stiffness
Swelling
Complex Regional Pain Syndrome
Need for further surgery

Failure to relieve symptoms
Worsening pain
Bleeding
Neurovascular deficit or injury
Risk of anaesthetic
Irregularity to the nail bed

If you experience any problems or have any concerns following your surgery, please do not hesitate to contact the office. Mr. Lawson-Smith’s staff with ensure that A/Prof Matthew Lawson-Smith is kept informed of what is occurring and will advise you the best course of action.

If you are unable to reach the office, please do not hesitate to contact your GP or if it is an emergency, please present to your nearest Emergency Department.