Volumen 64, Número 3 Revista de la Facultad de Medicina

Publicado

2016-07-01

Recommendations on treatment of nail and fingertip injuries in children. Cases series and literature review

Recomendaciones de tratamiento en lesiones de la uña y punta de los dedos en la infancia. Serie de casos y revisión

Palabras clave:

Hand Injuries, Hematoma, Paronychia, Wounds and Injuries, Nail Diseases (en)
Traumatismos de la mano, Hematoma, Paroniquia, Heridas y traumatismos, Enfermedades de la uña (es)

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Autores/as

  • Enrique Vergara-Amador Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Surgery - Orthopedics and Traumatology Unit - Bogotá, D.C. - Colombia. Fundación Hospital de la Misericordia - Unit Orthopedics - Bogotá, D.C. - Colombia.
  • Sergio Castillo Pérez Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Surgery - Orthopedics and Traumatology Unit - Bogotá, D.C. - Colombia.
  • Wilson Tovar Cuellar Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Surgery - Orthopedics and Traumatology Unit - Bogotá, D.C. - Colombia.

Introduction: Nail and fingertip injuries in children are very frequent and may range from a simple nail or fingertip injury to amputations.

Objective: To present a series of cases with their clinical and demographic characteristics and to describe the current concepts for the treatment of these injuries.

Materials and methods: A series of cases presenting fingertip injuries was analyzed for six months. Epidemiology of injuries is described and the current concepts of their treatment are reviewed.

Results: 60% of the injuries analyzed in this study occurred in male subjects; 88% of patients suffered crush injuries, the nail was affected in 98% of the cases, sterile matrix damage was observed in 64% and germinal matrix damage was experienced in 34% of the cases. The soft tissue around the finger was affected in 40% of the cases and associated fractures were observed in 55% of the cases.

Conclusion: Fingertip crush caused by closing doors was the most frequent injury, which implied a higher involvement of the nail. An adequate treatment focused on the anatomic repair of the nail bed, the relocation of the nail plate and, in some cases, the use of flaps to cover defects in the soft tissue is ideal for this type of injuries, and must be provided as fast as possible to avoid secondary deformities.

Introducción. En niños, son frecuentes las lesiones de la uña y de la punta de los dedos; estas varían desde traumas en la uña y el pulpejo hasta amputaciones.

Objetivos. Describir una serie de casos con sus características clínicas y demográficas y exponer el estado actual del tratamiento de estas lesiones.

Materiales y métodos. Se analiza una serie de casos con lesiones de punta de dedo durante seis meses. Se describe la epidemiología y se revisa el estado actual de tratamiento.

Resultados. El 60% de las lesiones evaluadas se presentaron en varones, 88% tuvieron trauma por aplastamiento, 98% compromiso de la uña, 64% afectación en la matriz estéril, 34% en la matriz germinal y 40% en el pulpejo; 55% de los casos sufrieron fracturas asociadas.

Conclusiones. La lesión por aplastamiento fue lo más frecuente, con mayor compromiso de la uña, predominando la contusión por cierre de puertas. Un buen tratamiento enfocado en la reparación anatómica de la matriz ungueal, reposición de la uña y, en algunos casos, uso de colgajos para cubrir los defectos en el pulpejo es el procedimiento ideal para este tipo de lesiones y debe hacerse rápidamente para evitar deformidades secundarias.

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