Late diagnosis and treatment of crush injuries of the fingertip in children.

Crush injuries of the fingertip are common in childhood. In the course of six months seven cases presented to our department, five of which were S III type injuries [Van Beek et al., Hand Clinics 1990; 6(1): 23-35], that is a sterile matrix laceration with a tuft fracture. In all but one case the severity of the injury was not appreciated at initial presentation leading to an average delay in definitive treatment of 6.6 days. Junior doctors need to be aware of the potential severity of these injuries and the difficulty in their diagnosis. Radiographs should routinely be taken and the presence of a fracture should strongly suggest the presence of a nailbed injury. Despite delays in diagnosis definitive treatment can result in good cosmetic and functional results even after a delay of up to two weeks.