Primary care of fingernail injuries.

The primary care physician has a profound influence on the prevention of deformity and disability resulting from fingernail injuries. Prompt recognition and precise repair of the disrupted nailbed consistently result in successful nail restoration. For injuries with a substantial subungual hematoma or a displaced phalangeal fracture, optimal treatment requires removal of the nailplate, reduction of the fracture, and meticulous repair of the nailbed. Even with severely fragmented or avulsion injuries, the results of an accurate primary repair are generally far superior to those of corrective surgery for established fingernail deformities. Skillful primary repair is the best method of managing the vast majority of fingernail injuries.