S61.111

Clinical Causes: Accidental cuts from knives, glass, or other sharp objects Crushing injuries that lead to tearing of the skin and nail damage Falls or impacts where the thumb is forcibly injured Getting caught in machinery or doorways with sharp edges Biting or biting injuries that result in skin tears and nail injury

Key Symptoms: Pain localized to the thumb, especially around the nail area Bleeding from the wound site Swelling and tenderness around the injury Visible tear or cut in the skin of the thumb Damage or distortion to the nail plate, which may appear broken, torn, or detached Possible exposure of underlying tissues if the injury is deep Possible signs of infection, such as redness, warmth, or pus, if not properly treated

Diagnosis Path: Diagnosis primarily involves a physical examination by a healthcare professional. The practitioner will assess the extent of the skin tear, examine the nail for separation, breakage, or damage, and check for signs of infection or underlying injury. In some cases, imaging studies like X-rays may be ordered if there’s suspicion of fractures or foreign bodies not visible externally.

Treatment Protocols: Management of a laceration without a foreign body and with nail damage typically includes the following steps: - Cleaning the wound thoroughly to remove debris and reduce infection risk - Applying appropriate local anesthesia to minimize discomfort - Repairing the skin tear with sutures or adhesive strips, depending on the wound's size and location - Addressing nail injury by stabilizing, trimming, or replacing the nail if necessary - Prescribing wound dressings that promote healing and prevent infection - Providing tetanus prophylaxis if indicated - Educating the patient about keeping the wound clean and dry - Monitoring for signs of infection or other complications In cases where there is extensive nail or skin damage, or if the injury involves underlying tendons, nerves, or blood vessels, surgical intervention may be necessary. Follow-up care includes wound care instructions and possibly removal of sutures, alongside advice on signs of infection to watch for.