ABSTRACT
Small injuries of the fingertip, especially in children, can be treated conservatively. Shortening of the bone is rarely necessary. Injuries with a surface area of more than 1 cm2 and intact pulp can be closed with a skin graft. Skin grafts of full thickness are preferred to prevent contraction. Preferable donor sites are the amputated part itself, the hypothenar area, and for larger areas in order of preference the groin, medial upper arm and elbow crease. A subungual hematoma covering more than 50% of the surface area requires removal of the nail and repairing the nail bed with 6-0 absorbable sutures. The eponychium is kept open by replacing the old nail. In case of defects of the nail bed, a nail bed graft may be considered. This too belongs to the area of the hand surgeon.
