Fingertip injuries
Waruna De Alwis,
Waruna De Alwis
Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Search for more papers by this authorWaruna De Alwis,
Waruna De Alwis
Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Search for more papers by this authorDr Waruna de Alwis, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102, Australia. Email: [email protected]
Waruna de Alwis, MB BS, Emergency Medicine Registrar.
Abstract
Fingertip injuries are a potential cause of significant morbidity within the workplace and the community. Although they account for a low proportion of ED presentations, importantly they can frequently be managed entirely by emergency staff. A literature review was undertaken to identify the epidemiology, the assessment process and the management options for fingertip injuries as relevant to emergency medicine.
References
- 1 Goldner RD, Steranovic MV. Digital replantation at the level of the distal interphalangeal joint and the distal phalanx. J. Hand Surg. 1989; 14A: 214–20.
- 2 Russell RC, Casas LA. Management of fingertip injuries. Clin. Plast. Surg. 1989; 16: 405–25.
- 3 Murai M, Lau HK, Pereira BP, Pho RWH. A cadaver study on volume and surface area of the fingertip. J. Hand Surg. 1997; 22A: 935–41.
- 4 Ljungberg E, Rosberg H, Dahlin L. Hand injuries in young children. J. Hand Surg. 2003; 28B: 376–80.
- 5 Inglefield C, D’Arcangelo M, Kolhe P. Injuries to the nail bed in childhood. J. Hand Surg. 1995; 20B: 258–61.
- 6 Doraiswamy N, Baig H. Isolated finger injuries in children – incidence and aetiology. Injury 2000; 31: 571–3.
- 7 Routley V, Valuri J. Home injuries. Hazard March 1993; Edition 14, Victorian Injury Surveillance System, Monash University Accident Research Centre.
- 8 Laflamme L, Eilert-Petersson E. Injuries to pre-school children in a home setting: patterns and related products. Acta Paediatr. 1998; 87: 206–11.
- 9 Fetter-Zarzeka A, Joseph M. Hand and fingertip injuries in children. Pediatr. Emerg. Care 2002; 18: 341–5.
- 10 Baker G, Kleinert J. Digit replantation in infants and young children: determinants of survival. Plast. Reconstr. Surg. 1994; 94: 139–45.
- 11 Stathakis V, Cassell E. Overview of unintentional hospital-treated work injury, Victoria 1999–2002. Hazard Winter 2002; Edition 58, VISAR.
- 12 Gunatilaka A, Cassell E, Clapperton A. Preventing hand entrapment injury from doors. Hazard Summer 2005; Edition 59, VISAR.
- 13 Hauck R. Pulp nonfiction: microscopic anatomy of the digital pulp space. Plast. Reconstr. Surg. 2004; 113: 536–9.
- 14 Fleckman P, Allan C. Surgical anatomy of nail unit. Dermatol. Surg. 2001; 27: 257–60.
- 15 Brown R. Acute nail bed injuries. Hand Clin. 2002; 18: 561–75.
- 16 Lemperle G, Schwarz M. Nail regeneration by elongation of the partially destroyed nail bed. Plast. Reconstr. Surg. 2003; 111: 167–72.
- 17 Soucacos P. Indications and selection for digital amputation and replantation. J. Hand Surg. 2001; 26B: 572–81.
- 18 Evans D, Bernardis C. A new classification for fingertip injuries. J. Hand Surg. 2000; 25B: 58–60.
- 19 Muneuchi G, Tami M, Igawa K, Kurokawa M, Igawa H. The PNB classification for the treatment of fingertip injuries: the boundary between conservative and surgical treatment. Ann. Plast. Surg. 2005; 54: 604–9.
- 20
Martin C,
Gonzalez del Pino J.
Controversies in the treatment of fingertip amputations: conservative versus surgical reconstruction.
Clin. Orthop.
1998; 1: 63–73.
10.1097/00003086-199808000-00008 Google Scholar
- 21 Leclercq C. Management of fingertip injuries [Editorial]. J. Hand Surg. 1993; 18B: 415.
- 22 Zook EG, Doermann A. Management of fingertip trauma. Postgrad. Med. 1988; 83: 163–76.
- 23 Madden MR, Nolan E, Finkelstein JL et al. Comparison of occlusive and semi-occlusive dressing and effect of the exudate upon keratinocyte proliferation. J. Trauma 1989; 29: 924–30.
- 24 Terrill PJ, Varughese G. A comparison of three primary non-adherent dressings applied to hand surgery wounds. J. Wound Care 2000; 9: 359–63.
- 25 Williamson D, Sherman K, Shakespeare D. The use of semipermeable dressings in fingertip injuries. J. Hand Surg. 1987; 12B: 125–6.
- 26 O’Donovan DA, Mehdi SY, Eadie PA. The role of Mepitel silicone net dressings in the management of fingertip injuries in children. J. Hand Surg. 1999; 24B: 727–30.
- 27 Whittaker JP, Nancarrow JD, Sterne GD. The role of antibiotic prophylaxis in clean incised hand injuries: a prospective randomized placebo controlled double blind trial. J. Hand Surg. 2005; 30B: 162–7.
- 28 Sloan JP, Dove AF, Maheson M, Cope AN, Welsh KR. Antibiotics in open fractures of the distal phalanx? J. Hand Surg. 1987; 12B: 123–4.
- 29 Stevenson J, McNaughton G, Riley J. The use of prophylactic Flucloxacillin in treatment of open fractures of the distal phalanx within an accident and emergency department: a double blind randomized placebo-controlled trial. J. Hand Surg. 2003; 28B: 388–94.
- 30 Suprock M, Hood J, Lubahn J. Role of antibiotics in open fractures of the finger. J. Hand Surg. 1990; 15A: 761–4.
- 31 Stevenson TR. Fingertip and nail bed injuries. Orthop. Clin. North Am. 1992; 23: 149–59.
- 32 Douglas BS. Conservative management of Guillotine amputations of the finger in children. Aust. Paediatr. J. 1972; 8: 86–9.
- 33 Louis D, Palmer A, Burney R. Open treatment of digital tip injuries. JAMA 1980; 244: 697–8.
- 34 Ipsen T, Frandsen P, Barfred T. Conservative treatment of fingertip injuries. Injury 1987; 18: 203–5.
- 35 Mennen U, Wiese A. Fingertip injuries management with semi-occlusive dressing. J. Hand Surg. 1993; 18B: 416–22.
- 36 Goitz R, Westkaemper J. Soft tissue defects of the digits, coverage considerations. Hand Clin. 1997; 13: 189–205.
- 37 Bossley CJ. Conservative treatment of digital amputations. N. Z. Med. J. 1975; 82: 379–80.
- 38 Brown R, Zook E, Russell R. Fingertip reconstruction with flaps and nail bad grafts. J. Hand Surg. 1999; 24A: 345–51.
- 39 O’Shaughnessy M, McCann J, O’Connor T, Condon K. Nail re-growth in fingertip injuries. Ir. Med. J. 1990; 83: 136–7.
- 40 Raja Sabapathy S, Venkatramani H, Bharathi R, Jayachandran S. Reconstruction of fingertip amputations with advancement flap and free nail bed graft. J. Hand Surg. 2002; 27B: 134–8.
- 41 Simon R, Wolgin M. Subungual hematoma: association with occult laceration requiring repair. Am. J. Emerg. Med. 1987; 5: 302–4.
- 42 Roser S, Gellman H. Comparison of nail bed repair versus nail trephination for subungual hematomas in children. J. Hand Surg. 1999; 24A: 1166–70.
- 43 Skinner P. Management of traumatic subungual hematoma. Am. Fam. Physician 2005; 71: 856.
- 44 Seaberg D, Angelos W, Paris P. Treatment of subungual hematomas with nail trephination: a prospective study. Am. J. Emerg. Med. 1991; 9: 209–10.
- 45 Wei FC, Chang YL, Chen HC, Chuang CC. Three successful digital replantations in a patient after 84, 86, and 94 hours of cold ischemia time. Plast. Reconstr. Surg. 1988; 82: 346–50.
- 46 Moiemen N, Elliot D. Composite graft replacement of digital tips: 2. A study in children. J. Hand Surg. 1997; 22B: 346–52.
- 47 Michalko K, Bentz M. Digital replantation in children. Crit. Care Med. 2002; 30 (11 Suppl.): s444–7.
- 48 VanGiesen PJ, Seaber AV, Urbaniak JR. Storage of amputated parts prior to replantation – an experiment with rabbit ears. J. Hand Surg. 1983; 8: 60–5.
- 49 Yamano Y. Replantation of the amputated distal part of the fingers. J. Hand Surg. 1985; 10A: 211–18.
- 50 Lin T, Jeng S, Chiang Y. Fingertip replantation using the subdermal pocket procedure. Plast. Reconstr. Surg. 2004; 113: 247–53.
- 51 Heistein J, Cook P. Factors affecting composite graft survival in digital tip amputations. Ann. Plast. Surg. 2003; 50: 299–303.
- 52 Yamano Y. Replantation of fingertips. J. Hand Surg. 1993; 18B: 157–62.
- 53 Foucher G, Norris RW. Distal and very distal digital replantations. Br. J. Plast. Surg. 1992; 45: 199–203.
- 54 Merle M, Dautel G. Advances in digital replantation. Clin. Plast. Surg. 1997; 24: 87–105.
- 55 Patradul A, Ngarmukos C, Parkpian V. Distal digital replantations and revascularizations 237 digits in 192 patients. J. Hand Surg. 1998; 23B: 578–82.
- 56 Hirase Y. Salvage of fingertip amputated at nail level. Ann. Plast. Surg. 1997; 38: 151–7.
- 57 Kim WK, Lim JH, Han JH. Fingertip replantations: clinical evaluation of 135 digits. Plast. Reconstr. Surg. 1996; 98: 470–6.
- 58
Tamai S.
Twenty years’ experience of limb replantation – review of 293 upper extremity replants.
J. Hand Surg.
1982; 7A: 549–56.
10.1016/S0363-5023(82)80100-7 Google Scholar
Citing Literature
