Ver el código de «Nail avulsion»

==Background==
*Generally results from blunt trauma

[[File:Human nail anatomy.jpg|thumb|A. Nail plate; B. lunula; C. root; D. sinus; E. matrix; F. nail bed; G. hyponychium; H. free margin.]]

==Clinical Features==
[[File:PMC4029263 dp0402a18g002.png|thumb|Full nail avulsion. The lunula and nail bed are exposed. The lunula is pinkish-white in color with a smooth surface. The nail bed is bright red in color with longitudinal dermal ridges stretching from the lunula to the distal groove.]]
*Nail completely or partial removed from nailbed
*May present with concomitant [[nailbed laceration]]

==Differential Diagnosis==
{{DDX distal finger}}

{{Hand and finger injury DDX}}

==Evaluation==
*Clinical diagnosis
*Obtain xray to check for [[finger Fracture|fracture]], [[finger dislocation|dislocation]], and foreign body
*Detailed neurovascular exam noting sensation and capillary refill

==Management==
[[File:PMC3349021 10195 2011 161 Fig2 HTML.png|thumb|(a) Fingernail avulsion; (b) polypropylene nail substitute; (c) clinical result at 12 months.]]
*For partial avulsion, gently lift nail but do not remove to inspect nail bed for laceration
*For complete avulsion:
**Repair any [[nailbed laceration]]
**Replace nail into nailfold after cleaning nail and suture into place
**If no nail, place a non-adherent, petroleum containing gauze into nail fold. Can Also use aluminum wrapping of suture package as pseudo-nail to allow appropriate spacing for new nail to grow in. This should be left in place for 2-3 weeks.
**Wound should be re-evaluated in 3-5 days and gauze replaced<ref>Lammers, R.L. and Smith, Z.E. Chapter 35: Methods of Wound Closure.  In: Roberts, J ed. Roberts and Hedges' Clinical Procedures in Emergency Medicine. Elsevier; 2014:644-689</ref>

==Disposition==
*Discharge

==See Also==


==External Links==


==References==
<references/>

[[Category:Orthopedics]]
[[Category:Dermatology]]