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March 1954


AMA Arch Derm Syphilol. 1954;69(3):368. doi:10.1001/archderm.1954.01540150114013

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Surgical avulsion of the nail is a not uncommon therapeutic necessity. The nail is usually removed by traction after it has been bluntly separated from its bed. The infected nail is friable, and often difficult to remove. It crushes easily under the pressure of the hemostat, and adequate traction may be impossible to obtain. Piecemeal removal, then, is necessary, which increases the possibility that infected spicules will be left behind to reinfect the new nail. Profuse bleeding may occur after this procedure.

It is common knowledge that a fingernail will loosen and separate cleanly after injury severe enough to produce a large subungual hematoma. The hematoma acts as a blunt dissector, and, thus efficiently separates the nail from the bed. In an effort to duplicate this natural process, a subungual injection of water was attempted. Enough pressure to separate the nail was difficult to obtain, and fluid escaped backwards

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