Abstract

TORRES-FUENTES, Carlos Eduardo; HERNANDEZ-BELTRAN, Julián Andrés  and  CASTANEDA-HERNANDEZ, Diego Alejandro. Initial management of fingertip injuries: a treatment guide based on experience in the San Jose hospital (involving 91 cases). rev.fac.med. [online]. 2014, vol.62, n.3, pp.415-423. ISSN 0120-0011.  https://doi.org/10.15446/revfacmed.v62n3.39603.

Background. Fingertip injuries are the commonest upper limb injury and represent a major cause for emergency care in Colombia, leading to disability regarding employment and function due to amputation of the distal phalanx. Treatment of these injuries aims to restore fingertip function, thereby improving patients' quality of life. Objective. Proposing an effective management protocol for this type of injury. Materials and methods. This document presents 91 cases of patients having an admission diagnosis of fingertip injury. The research determined injury mechanism, gender, handedness and whether there was an injury or nail bed and associated fractures. An initial attempt was made at determining both clinical and surgical treatment according to Allen's classification; however, most injuries were unrelated and thus treatment options were described instead. Cutting tools caused most injuries, resulting in irregular lesions of soft tissue and nail loss. Repositioning the nail bed as well as a nail equivalency was paramount; this served as a splint in cases of associated fracture and a guide for the forthcoming tissue. Results. There was higher incidence in men than in women; the right hand (in most cases the dominant hand) was affected more and the second and third fingers were the most affected. The most frequently reported mechanism of injury was trauma resulting from being crushed with a short, blunt object. Conclusion. Allen's classification was not useful in any of the cases; the classification and management protocol suggested by the authors was thus followed.

Keywords : Amputation; Traumatic; reconstruction; fingers; hand injuries.

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