Narrow Results

There is no consensus regarding the optimal mode of managing the acute traumatic subungual haematoma in the hand. In this context the medical literature was searched systematically and the results analysed. The final dataset consisted of four articles. The complication rates of all forms of treatment were low. The outcome in terms of nail cosmesis was generally good, although the method of outcome measurement was variable in nature. There was no difference in cosmetic outcome when comparing nail bed repair with simple decompression. In conclusion the outcome in terms of nail cosmesis does not appear to be affected by the mode of treatment. The acutely painful subungual haematoma should be decompressed, whether this be done by trephining or nail removal. Future research includes the potential for a randomised controlled trial to compare nail bed repair with trephination.

The purpose of this study was to demonstrate the accuracy of a novel, surgically useful guide that could place a drill or pin within the femoral head. The radiolucent guide for attachment to the lateral femoral cortex was tested for reproducibility on cadaveric specimens simulating a surgical procedure. The guide allows selection of the three-degree freedom angle of insertion of a drill or pin via two circular channels allowing anterior–posterior or superior–inferior adjustment. The guide can accurately place a pin tip within 2.5–3.8 mm of a desired location. We conclude this guide could be used to accurately place a fibular graft in an osteonecrotic lesion, or place pins or nails during many different surgical procedures such as fractures or slipped capital femoral epiphysis.