Concurrent pyogenic granuloma and onychomadesis after splint application: a case report

Abstract

Splint immobilization is commonly used after hand trauma to protect repaired structures and prevent further injury. Although splinting is frequently associated with joint-related complications, periungual pyogenic granuloma (PG) and onychomadesis are extremely rare. We report a patient with glass-related finger injuries who underwent extensor tendon repair and skin closure, followed by 4 weeks of splint immobilization. After splint removal, periungual PG and onychomadesis developed simultaneously in two fingers. Histopathological examination confirmed PG. Both lesions resolved spontaneously during conservative management, and normal nail growth resumed. This case demonstrates the rare occurrence of PG with onychomadesis after splint immobilization. Recognition of these benign changes is important because rapidly growing periungual nodules may be mistaken for malignant tumors, whereas nail shedding may be misinterpreted as evidence of a systemic disorder. Prompt identification of their benign nature may prevent unnecessary diagnostic procedures and aggressive interventions.