Fingernail or Toenail Avulsion

Presentation

Blunt trauma to the distal phalanx may result in nail avulsion, nail bed laceration, and distal phalanx fractures. The nail may be completely avulsed, partially held in place by the nail folds, or adhering only to the proximal nail bed ( Fig. 135.1 ). On occasion, an exposed nail bed will have a pearly appearance, with minimal bleeding, making it seem as if the nail is still in place when it actually has been completely avulsed. See the anatomy of the fingernail in Fig. 135.3 .