The fingertip is a very exposed part of the hand, and due to this the fingertip is one of the most common injuries seen in any hospital emergency department.
Injuries range from minor lacerations or crush injuries, and nail bruises called hematomas, to more serious injuries such as amputations of the distal tip of the finger or fractures of the distal phalanx (the end bone of the finger).
A key principle of treatment is to salvage as much length as possible.  It is essential to treat such cases immediately, or at least within the first seven to ten days, by the best possible method so that a pain problem does not develop.  The nerves are extremely sensitive in this area, so normal skin cover is important.  Also, appropriate treatment of the bone, management and repair of nail injuries, or split-thickness skin grafts may be needed.
If there is a crush injury to the nail with bruising beneath the nail, this may indicate a serious injury to the nailbed.  Often, in these situations, the nail will need to be removed.  This is followed by reconstruction of the underlying tissues under the operating microscope, and then replacement of the nail.  Sometimes the nail is so severely damaged that a plastic or prosthetic nail is needed as a temporary measure while the new nail grows out.  It takes approximately four months for a nail to grow completely from the base of the nail, where this growth occurs, to the end of the finger.