Management of uncomplicated nail bed lacerations presenting to a children's emergency department

This study examined the mechanisms of injury and the pattern of care for children who presented to the emergency department with uncomplicated nail bed lacerations.

A retrospective chart review was conducted from January 2004 to December 2007 for all children younger than 18 years who presented to a tertiary children's hospital with an uncomplicated nail bed laceration.

There were 84 cases of uncomplicated nail bed injuries for more than a 4-year period. Sixty percent of the subjects were males. The mean age was 5.3 (SD, 4.1) years. Most injuries occurred at home (58%), and the most common mechanism of injury was a door (67%). Approximately 40% of patients were treated by emergency physicians. There was no significant difference in acute and chronic complications or in the length of stay in the emergency department, between patients treated by emergency physicians and by plastic surgeons.

Most nail bed injuries in children occur at home, and the door seems to be the major mechanism of injury. Approximately 57% of these are children younger than 5 years. Only 42% of uncomplicated nail bed lacerations are treated by emergency physicians, yet there is no significant difference in outcomes between plastic surgeons and emergency physicians. Our study suggests that there is a role in public education for primary prevention, and with proper training, pediatric emergency physicians can treat uncomplicated nail bed lacerations.