Presentation The patient has caught a finger in a car door or dropped a heavy object on an exposed toe, causing a painful deformity. The base of the nail will be found resting above (on top of) the eponychium instead…
Presentation The patient has either cut into the nail with a sharp edge or crushed a finger (commonly in a door). With shearing forces, the nail may be avulsed from the nail bed to varying degrees, and there may be…
Presentation After coming into contact with marine life, the patient may seek medical attention because of local pain, swelling, or skin discoloration. While more common in coastal areas, envenomation can also occur from handling animals kept in saltwater aquaria. Marine…
Presentation Histories of animal bites are usually volunteered, but the history of a human bite, such as one obtained over the knuckle during a fight, is more likely to be denied or explained only after direct questioning. Dog bites make…
Presentation A patient presents with swelling of the lower extremity. It may be mildly painful, but there has been no trauma. The patient denies any fever, chest pain, difficulty breathing, or other systemic symptoms. Peripheral edema can be categorized in…
Presentation Lacerations arise from either a cut with a sharp object or direct blunt trauma that exceeds the tensile strength of the skin. Consequently, lacerations may be linear ( Fig. 140.1 ) or stellate/complex with various amounts of tissue loss.…
Presentation A sharp metal object, such as a needle, heavy wire, or nail, is driven into the soft tissue. The patient may arrive with an additional large object attached (e.g., a child who has stepped on a nail going through…
Presentation The patient complains of a paint chip or wooden sliver under the nail. Due to high sensory nerve density, these injuries are often quite painful. Most subungual foreign bodies are completely visible and are lodged under the distal portion…
Presentation The patient has been snagged with a fishhook and arrives with it embedded in the skin ( Fig. 137.1 ). This most commonly occurs on the hand, face, scalp, or upper extremity but can involve any body part. Removal…
Presentation A patient arrives holding a bandage over a missing fingertip. The patient may or may not have brought along the avulsed tissue. Traumatic finger pad injuries are common. The mechanisms of injury can be diverse: A knife, a meat…