This common injury should be suspected whenever a patient has a subungual hematoma in the proximal half of the nail bed. In most closed tuft fractures, the nail plate acts as a splint and healing is uneventful. Some patients may benefit from a small splint (Fig. 41), but this should only span the distal phalanx, not crossing the distal interphalangeal joint - otherwise, it may transfer of the force of the profundus tendon to the fracture site and either delay or prevent union.
Distal Phalanx Tuft Fractures