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[Fingertips and nailbed injuries in children. Apropos of 241 cases]
Insights
Proper management of pediatric fingertip trauma is crucial for optimal outcomes. Careful nailbed repair, including nail removal for exploration and absorbable sutures, significantly reduces nail deformities and improves function.
Area of Science:
- Pediatric surgery
- Trauma care
- Hand surgery
Context:
- Fingertip trauma in children presents unique management challenges.
- The long-term functional and esthetic outcomes of pediatric fingertip injuries are often debated.
- Previous studies have not definitively established optimal treatment protocols.
Purpose:
- To evaluate the long-term outcomes of fingertip trauma in children.
- To analyze the impact of different management strategies on functional and esthetic sequelae.
- To provide evidence-based recommendations for the treatment of pediatric fingertip injuries.
Summary:
- A retrospective analysis of 241 pediatric fingertip trauma cases with a mean follow-up of 2.5 years was conducted.
- Nail deformities (42%) and sensory disturbances (40%) were common sequelae.
- Suturing of nailbeds resulted in a higher rate of normal nail regrowth (86%) compared to non-sutured nailbeds (52%).
Impact:
- Optimal management, including thorough nailbed exploration and repair with absorbable sutures, minimizes long-term functional and cosmetic deficits.
- Early and accurate treatment of nailbed injuries is essential to prevent sequelae.
- This study underscores the importance of parental counseling regarding potential risks of nail regrowth interference.
Purpose Of The Study:
The authors studied long-term outcome of fingertip trauma in children, as its management remains controversial.
Material And Methods:
241 cases with a mean follow-up of 2.5 years were analysed. Epidemiologic data were studied as well as functional and esthetic sequelae regarding nailbed as well as fingertips, depending on treatment.
Results:
42 per cent nail deformities, and 40 per cent sensory disturbances were found. Only 14 nailbeds were sutured, leading to 12 normal nails (86 per cent) when not sutured nailbeds led to 52 per cent normal nails. We obtained 60 per cent excellent and good results.
Discussion:
We compared our results with those of other authors performing the same procedures; when most care is given to perionychium repair fewer nail deformities are found. The nail must be removed in order to explore the whole nailbed, using optic magnification. A small and adsorbable suture is preferable for better repair. Every injury involving the nail is liable to interfere with nail regrowth: parents and child must be warned of this risk.
Conclusion:
The importance of adequate management, a good overall view, and accurate treatment of nailbed injuries, especially in children, should be stressed, in order to avoid functional and cosmetic sequelae.