Tuft fractures often result from a crush injury to the distal tip of a finger. Closed tuft fractures can be managed with analgesia alone. A digital block and drainage of a subungual hematoma can be considered for pain control. Open tuft fractures require exploration and extensive irrigation after analgesia (often with a digital block). The nail bed should be sutured to cover exposed bone. Local wound care is the best strategy to prevent an infection, but if there is gross contamination, a short course of antibiotics can be considered. Typically, these fractures do not require splinting.

 

extensive irrigation

fingertip crush injury

Fingertip fracture

fingertip splint

fracture distal phalanx

subungual hematoma

Tuft fracture