Abstract

FINGERTIP AMPUTATIOS EPIDEMIOLOGY, EVALUATION AND TREATMENT

*Dr. Maram Ahmed Ameen Mamshy, Dr. Mohammed Tarish Ali Al Quraishy and Dr. Aws Mohammad Matrood AlJanabi

ABSTRACT

Background: Fingertip injuries are the most common hand injuries occurring in all age groups and can result from occupational and recreational causes. The primary goal of treatment of an injury to the fingertip is a painless fingertip with durable and sensate skin. Knowledge of fingertip anatomy and the available techniques of treatment is essential. Patients and Methods: A prospective study performed on 40 patients whom presented to Sulaimanya Emergency Hospital suffering from fingertip amputations in the period from 10/1/2010 to 10/1/2011. Results: our study reveals that male are vulnerable to fingertip amputations more than females by a ratio 4:1 in which 60% of the injuries were due to occupational causes versus 40% caused by non occupational accidents. The dominant hand was affected in 82.5% of cases and mostly affected the ring finger. Transverse fingertip amputations accounted for the higher incidence regarding injury mechanisms. Conclusion: For injuries with soft-tissue loss and no exposed bone, healing by secondary intention or skin grafting is the method of choice. When bone is exposed, coverage with a local advancement flap should be considered. If the angle of amputation does not permit local flap coverage, a regional flap (cross-finger or thenar flap) may be indicated. If the patient is not a candidate for a regional flap because of advanced age, osteoarthritis, or other systemic condition, shortening with primary closure is preferred. Composite re-attachment of the amputated tip may be successful in young children.

Keywords: Transverse fingertip amputations accounted for the higher incidence regarding injury mechanisms.