Daniel J. Pallin, MD, MPH reviewing Gungor F et al. Am J Emerg Med 2016 Jun 18.

Ultrasound was highly sensitive and specific for nail bed injury; however, injuries that do not involve the nail folds don't require repair anyway.

Subungual hematoma resulting from blunt trauma may be accompanied by laceration of the nail bed. Ascertaining the presence of a laceration requires removal of the nail, an invasive procedure. Investigators in Turkey studied the accuracy of point-of-care ultrasound for detection of nail bed injuries among 45 patients with trauma to a nail. The gold standard was nail removal and inspection of the nail bed, plus plain radiography to detect fractures.

Overall, 33 patients had nail bed injury and 16 had distal phalanx fracture. Ultrasound had a sensitivity of 93% and a specificity of 100% for detecting nail bed injury. For distal phalanx fracture, sensitivity was 100% and specificity was 98%.

CITATION(S):

Gungor F et al. The value of point-of-care ultrasound for detecting nail bed injury in ED. Am J Emerg Med 2016 Jun 18; [e-pub].

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