Fingertip & Nail Bed Injuries
Cuts, crush injuries and partial amputations at the fingertip can involve skin, nail, bone, tendon and sensation.
Types of injury
Fingertip trauma ranges from a simple laceration to nail-bed injury, tuft fracture, tissue loss or partial amputation.
Initial assessment
The clinician checks circulation, sensation, tendon function, contamination and the amount of missing tissue. X-rays are commonly used when a fracture is possible.
Nail-bed injuries
A lacerated nail bed may need careful repair, especially when the nail plate is displaced or there is an associated open fracture.
Treatment
Small wounds may heal with dressings. Larger defects may require closure, local flap coverage, grafting or revision depending on the level and exposed structures.
Pain and sensitivity
The fingertip has dense sensory innervation. Hypersensitivity, cold intolerance and tenderness can persist during recovery and may improve gradually with desensitisation.
Return of function
Protecting the wound while maintaining motion in uninjured joints helps reduce stiffness. Work restrictions depend on wound stability and occupation.
A pale or cold fingertip, uncontrolled bleeding, major tissue loss or partial/complete amputation requires urgent specialist assessment.