Fairbairn Neil
St Johns Hospital, Livingston, West Lothian, Scotland.
Pediatr Emerg Care. 2012 Apr;28(4):363-5. doi: 10.1097/PEC.0b013e31824d9d57.
Nail bed injuries are the commonest pediatric hand injuries presenting to the emergency department. If managed correctly, the patient recovers quickly and complications are rare. However, failure to appreciate the complex anatomy of the perionychium and the importance of exploration, washout, and repair can result in devastating complications. These injuries are often underestimated and, consequently, delegated to the most junior and inexperienced staff. The case of a 6-year-old boy with a flexor sheath infection and devitalized fingertip 1 week after injury is presented. Emphasis is placed on the soft tissue and underlying bony injury that was overlooked at initial presentation, and how this led to serious infection requiring amputation. Thorough assessment of these common injuries and a high index of suspicion are essential.
甲床损伤是儿科患者急诊就诊时最常见的手部损伤。如果处理得当，患者恢复迅速且并发症罕见。然而，若不了解甲周组织的复杂解剖结构以及探查、冲洗和修复的重要性，可能会导致严重的并发症。这些损伤常常被低估，因此往往交由最年轻、经验最少的工作人员处理。本文介绍了一名6岁男孩受伤1周后发生屈指腱鞘感染和指尖坏死的病例。重点强调了初次就诊时被忽视的软组织和潜在骨损伤，以及这是如何导致严重感染并需要截肢的。对这些常见损伤进行全面评估并保持高度怀疑至关重要。
