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Crushed Fingernail

Crushed Fingernail Surgery with a nail bed laceration is explained by Dallas Hand Surgeons Dr. David and Solomon Azouz

Dallas Plastic and Hand Surgeons Dr. David and Solomon Azouz review Crushed Finger Surgery: symptoms, surgical treatment, cost, insurance, and recovery.

What is a crushed fingernail with a nail bed laceration?

Crushed fingernail surgery repairs a crushed fingernail with a nail bed laceration.  A traumatic injury to the finger nail occurs when the fingernail is crushed or caught by something such as a hammer, heavy object, machinery, or in a door, and there is resulting damage to the nail, nail bed, and exposure of the underlying bone known as the distal phalanx.  What are the common causes of nail bed laceration or crush injuries to the fingers?

Common causes for a crushed fingernail with nail bed laceration is someone who has experienced a traumatic injury to their fingernail at home or work.  Crushed fingernails with nail bed lacerations are often caused when the fingertip is crushed or caught by something such as a hammer, heavy object, machinery, or a door.


Symptoms of a nail bed crush or laceration include:




Subungual hematoma (bruising underneath the nail)

Bleeding (depending on severity)

Discoloration or deformity to the fingernail

Limited range of motion of the finger

Exposure of the underlying bone

Nail loss or separation

Who needs surgery for a cut nail bed or crushed fingertip?

Crushed fingernail surgery is for those patients with exposed bone, significant subungual hematoma, open wounds, and displaced fractures of the distal phalanx necessitating repair of the nail bed and fingertip.  Urgent consultation with a hand surgeon like Dr. Azouz is critical to prevent deformity, infection, and nail deformity.

What are the benefits of repairing a crushed fingertip or cut nail bed?

The benefits of repairing a crushed fingernail or nail bed laceration are restoring the function of the finger and potentially having normal nail growth of the injured fingernail. If a crushed fingernail goes untreated, the patient can experience chronic pain and discomfort in the injured fingernail.  Furthermore, it is critical to cover exposed bone and remove damaged tissue because if left untreated patients can go on to have infections such as osteomyelitis.  Osteomyelitis is a serious infection of the bone which can necessitate bone removal or long-term use of antibiotics.  

How is crushed fingernail surgery performed?

Dr. Azouz performs nail bed reconstructions and nail bed repairs on patients who have crushed their nail beds at work or home. Dr. Azouz will determine if the patient will require surgical or nonsurgical treatment for their nail bed laceration injury. During nail bed repair surgery with Dr. Azouz, he will surgically repair the nail bed.  This is done with specialized sutures.  If necessary, the nail bed repair can be combined with repairing tendons, fractures, and other injuries.  

What type of anesthesia is used for a crushed fingertip?

Dr. Azouz uses a combination of local anesthetic, an axillary block, and sedative medication during most hand and finger procedures.  Sedative medication is given through an IV which helps the patient feel relaxed during the procedure. With the use of sedative medication, the patient breathes on their own versus with general anesthesia where a machine breathes for the patient. Dr. Azouz prefers sedation for his hand and finger procedures as his patients have a quicker recovery period and less postoperative nausea. 

Often isolated nail bed lacerations can also be performed with local anesthetic alone.  Local anesthetic is injected to numb the finger.

What is the recovery from a crushed fingernail surgery?

Nail bed reconstruction surgery performed by Dr. Azouz is done as an outpatient procedure. This means that the patient goes home the same day as their surgery. Dr. Azouz recommends taking the rest of the day to rest and elevate the surgical arm. The patient will have follow-up appointments with Dr. Azouz in his Dallas-based practice. During their following-up appointment, Dr. Azouz will give detailed instructions on the next steps of the patient’s healing process.

If you have had a crush on your finger call 972-702-8888 to book your appointment with Dr. Azouz in Dallas.  

Crushed Fingernail Frequently Asked Questions

What is the cost of nail bed reconstruction surgery?

The cost of the repair of a crushed fingernail depends on the severity of the injury. During your consultation Dr. Azouz will determine the severity of your injury and the cost. If the patient’s injury happens at work, Dr. Azouz coordinates with a multitude of workers’ compensation carriers.

Can normal function and nail growth be restored after a finger crush?

The results of the crushed fingernail surgery can depend on the severity and location of the nail bed laceration. However, in most cases, the patient can regain the function of the crushed finger and can continue to have normal nail growth after surgery.

How do I know if I broke my fingertip?

An X-ray is performed to determine if there is a fracture of the bone of the finger tip known as the distal phalanx.  

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