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We retrospectively reviewed the outcomes of 54 patients treated with occlusive dressings (OD) (27 patients) or local flap (LF) coverage (28 patients) for fingertip amputations with bone exposure. All patients healed completely within a mean of 5 weeks in the OD group and 3.5 weeks in the LF group. At a mean follow-up of 26 months (range 12-38), 2-point discrimination was significantly better in the OD group (4 mm) than the LF group (6 mm). Proximal interphalangeal joint (PIP) stiffness was more common in the LF group, affecting one-third of patients. A cost analysis showed that ODs were 6.5 times less expensive than LFs performed in the operating theatre. OD appears to be a reliable and more cost-effective alternative to LF for treating zone 2 and 3 fingertip amputations with exposed bone, with similar healing time, better tactile discrimination and a lower rate of PIP joint stiffness. IV.
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http://dx.doi.org/10.1177/17531934241258860 | DOI Listing |
Microsurgery
September 2025
Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Background: Fingertip amputations are a common form of hand trauma and often require soft tissue reconstruction when replantation is not feasible. The reverse homodigital island flap (RHI) and the digital artery perforator flap (DAP) are two widely used techniques for fingertip reconstruction; however, direct comparisons of their clinical outcomes remain limited.
Methods: This retrospective study analyzed 39 patients who underwent either RHI (n = 20) or DAP (n = 19) procedures for fingertip injuries.
JPRAS Open
September 2025
Department of Plastic and Reconstructive Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 9200293, Japan.
This case report describes the reconstruction of two adjacent fingertip pulp defects using a single free medial plantar artery perforator flap. A 30-year-old man sustained traumatic amputations of the left index and middle finger pulps. A flap harvested from the medial plantar region was used to resurface both defects and was successfully anastomosed to the digital vessels of the index finger.
View Article and Find Full Text PDFHand Surg Rehabil
June 2025
Hospital for Traumatology and Orthopaedics, Ho Chi Minh City, Viet Nam. Electronic address:
Purpose: This study aimed to evaluate the outcomes of treating exposed bone fingertip amputations using the secondary intention healing method, and to analyze the correlation between the severity of the injury, as defined by the Allen classification, and the results of the treatment.
Methods: A prospective descriptive study was conducted on 40 patients with fingertip amputation of Allen types 2-4 and exposed bone (≤2 mm) from May 2023 to January 2024. Patients were treated using the secondary intention healing method with a multi-layer moist dressing protocol, which included castor oil, non-adhesive Urgotul gauze, saline-moistened gauze and rubber glove fingertip coverage.
J Hand Surg Glob Online
May 2025
Hand Surgeon at Clínica de Mano, Montevideo, Uruguay.
Purpose: Fingertip trauma and amputations, when not treated correctly, can evolve unfavorably, leading to pain, loss of strength, and tactile difficulties. Post-traumatic nail changes are not just a cosmetic complaint as the nail, along with its protective function, also helps to stabilize the fingertip, adding to pinching motion. There are techniques that provide the nail complex improvement for the treatment of post-traumatic sequelae, thus enhancing fingertip function and aspect.
View Article and Find Full Text PDFJ Pediatr Soc North Am
May 2025
Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children and University of Texas Southwestern Medical Center, Dallas, TX, USA.
Background: Pediatric fingertip injuries are very common; however, treatment varies greatly depending on geographic location and surgeon. A paucity of data exists on how emergency department practitioners and hand surgeons should treat these injuries. We sought to develop consensus around treatment guidelines for these injuries.
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