Fingertip trauma in children from doors

Fingertip and nailbed trauma caused by doors is common in children, occurring when fingers are either shut in the door itself or are trapped in the hinge as the door is closed. An audit was carried out over five months of all fingertip and nailbed injuries due to trauma from a door. One hundred and eighty eight children, 2% of all attendances in this period, had sustained such trauma, 39% of these occurring in children under four years of age. One hundred and forty seven children (75%) had sustained relatively minor soft-tissue injury to the finger, However the remaining forty seven (25%) of the injuries sustained were more serious e.g. Avulsion of the nail from the nailbed or amputation of part of the fingertip and 29 (15%) of all the cases required a general anaesthetic for exploration, cleaning and repair. The Plastic Surgery department followed up these 29 children and 71 Accident & Emergency follow-up appointments were generated by the remaining injuries. The incidence of significant injury was higher than expected and caused considerable distress to both the children and their parents, It is suggested that home safety protocols should feature advice on how to avoid these injuries.