Simon R R, Wolgin M
Am J Emerg Med. 1987 Jul;5(4):302-4. doi: 10.1016/0735-6757(87)90356-1.
Subungual hematomas are one of the most common injuries involving the hand. On conducting a literature search, we were unable to find any studies that investigated the association between subungual hematomas, fractures, and the presence of an occult laceration of the nail bed requiring repair. Forty-seven consecutive patients who presented to the emergency department with subungual hematoma involving more than one fourth of the nail bed were included in this study. In these cases, radiographs were taken, and the nail was lifted to look for a laceration. In the subgroup of patients who had subungual hematoma associated with a fracture, all of them had a laceration requiring repair. Patients with a subungual hematoma greater than one half of the size of the nail bed had a 60% incidence of a laceration requiring repair. The authors believe that patients presenting with a subungual hematoma involving greater than one half of the nail surface and a fracture of the distal phalanx should have the nail lifted and the nail bed explored and repaired.
甲下血肿是手部最常见的损伤之一。在进行文献检索时，我们未能找到任何研究来调查甲下血肿、骨折与需要修复的甲床隐匿性裂伤之间的关联。本研究纳入了47例连续因甲下血肿就诊于急诊科且甲下血肿累及超过四分之一甲床的患者。在这些病例中，拍摄了X线片，并掀起指甲以查找裂伤。在伴有骨折的甲下血肿患者亚组中，所有患者均有需要修复的裂伤。甲下血肿大于甲床一半大小的患者，有60%的几率出现需要修复的裂伤。作者认为，对于甲下血肿累及超过一半指甲表面且伴有远节指骨骨折的患者，应掀起指甲并探查和修复甲床。
