Fingertip Reconstruction in Hand Injuries
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Abstract
Fingertip amputations are a significant issue in the United States, with approximately 45,000 performed annually, with a 7.5 per 100,000 incidence rate. The primary cause of finger injuries is metal objects and bladed hand instruments, which can lead to cuts, loss of limbs, or damage to nerves and blood vessels. Therapy aims to restore sensation, long-lastingness, and bone support for nail development. Inadequate management can result in cosmetic issues, cold sensitivity, skin soreness, and persistent impairment in functionality. Nail bed injuries, such as lacerations, avulsions, and crush injuries, can result in post-traumatic fingertip amputation. Physical examinations are necessary to evaluate the functional and sensory capabilities of the damaged finger. Surgical intervention is necessary for severe cases, with primary closure or revision amputation being the preferred procedure. Full-thickness skin grafting is also used for fingertip amputations, preserving the structure of the recipient's fingers and addressing areas with insufficient skin.
Flap repair is a method for managing fingertip amputations, using skin from another area or distant region. Local flaps are best for small covering areas, while regional flaps are used for extensive incisions. These flaps prevent prolonged immobilization and allow for a return of feeling in the fingertip. Post-amputation complications include delayed wound healing, nail abnormalities, heightened sensitivity, pain, intolerance to cold, scar retraction, limited finger movement, persistent ulcers, infection, and loss of tissue flaps. Inadequate management of fingertip amputations can lead to cosmetic flaws, reduced tolerance to cold, and increased skin sensitivity.
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References
I. Hong, M. K., Park, J. H., Koh, S. H., Lee, D. C., Roh, S. Y., Lee, K. J., & Kim, J. S. (2020). Microsurgical Free Tissue Options for Fingertip Reconstruction. Treatment of fingertip injuries and nail deformities, An Issue of Hand Clinics, E-Book, 37(1), 97-106.
II. Kawaiah, A., Thakur, M., Garg, S., Kawasmi, S. H., & Hassan, A. (2020). Fingertip injuries and amputations: a review of the literature. Cureus, 12(5).
III. Jerome, J. T. J., & Malshikare, V. A. (2022). Fingertip injuries outcome score. Plastic and Reconstructive Surgery–Global Open, 10(6), e4386.
IV. Karakas, A. O., & Yuce, E. (2020). Evaluation of pediatric fingertip injuries using etiology, demographics and therapy. The Medical Bulletin of Sisli Etfal Hospital, 54(3), 306.
V. Abu-Ghname, A., Lazo, D., Chade, S., Fioravanti, A., Colicchio, O., Alvarez, D., ... & Maricevich, M. (2022). The first dorsal metacarpal artery perforator free flap: The Comet Flap. Plastic and Reconstructive Surgery, 150(3), 671e-674e.
VI. Bravo, E., & Rodríguez-Merchán, E. C. (2022). Controversies in the Treatment of Fingertip Amputations in Adults: Conservative Versus Surgical Reconstruction. In Controversies in Orthopedic Surgery of The Upper Limb (pp. 247-263). Cham: Springer International Publishing.
VII. Chakraborty, S. S., Acharya, S., Goel, A. D., Sahu, R. K., Midya, M., & Kotu, S. (2022). A systematic review of the sensory outcomes of a standard cross-finger flap reconstruction for fingertip defects. The Journal of Hand Surgery (Asian-Pacific Volume), 27(05), 782-791.