Doom and Bloom: Injuries to the Nail Bed

The Altons at Doom and Bloom Medical have an article about nail bed injuries and how to treat them. If you’re squeamish, there are a few bloody and/or squished finger photos in the article.

A fractured femur or a gunshot wound to the chest are major injuries that affect your chances of survival in disaster settings, but not all injuries are so extreme. “Minor” injuries can also impact the efficiency of a group member off the grid.  Of these, nailbed injuries are some you’ll commonly see.

You can imagine that nailbed injuries will be more common when untrained (and perhaps careless) people perform tasks to which they’re not accustomed. The failure to use work gloves and boots may also increase the risk of mishaps.

NAIL ANATOMY

Your fingernails and toenails are made up of protein and a tough substance called keratin. They are very similar to the claws of animals.  Any issue relating to nails is referred to as “ungual” ” (from the latin word for claw: unguis).

The nail consists of several parts:

The nail plate:  this is the hard covering of the end of your finger or toe; what you normally consider to be the nail.

The nailbed:    the skin directly under the nail plate.  Made up of dermis and epidermis just like the rest of your skin, the superficial epidermis moves along with the nail plate as it grows. Vertical grooves attach the superficial epidermis to the deep dermis.  In old folks like me, the nail plate thins out and you can see the grooves if you look closely.  Like all skin, blood vessels and nerves run through the nailbed.

The nail (germinal) matrix:  the portion or root at the base of the nail under the cuticle (the cuticle is also called the eponychium) that produces new cells for the nail plate.  You can see a portion of the matrix in the  light half-moon (the “lunula”) visible at the base of the nail plate. This is the germinal matrix (actively makes new nail cells) and determines the shape and thickness of the nail; a curved matrix produces a curved nail, a flat one produces a flat nail.

TYPES OF NAIL INJURIES

There are various types of nail injuries. Amputations and fractures may occur due to trauma, but more commonly you’ll see…

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