Fingertip Lesions an Evaluation of Conservative Treatment Versus Free Skin Grafting

Holm, Axel; Zachariae, L

doi:10.3109/17453677408989160

Cited by 81 publications

(23 citation statements)

References 7 publications

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“…Usually, treatments for these injuries include primary closure, skin grafting, local soft tissue flaps and healing by secondary intention. 2 Soft tissue defects that are Ͻ 1.0 cm 2 have been treated conservatively, with diligent wound care alone, while those defects that are Ͼ 1.0 cm 2 have generally been approached surgically. 3 Surgical treatment, while an effective method of wound closure, is associated with substantial costs and notable scarring.…”

Section: Discussionmentioning

confidence: 99%

“…Group II (n ϭ 25) underwent surgical debridement, then reconstruction with a skin graft or local soft tissue flap as indicated. The frequency of each technique employed was recorded: primary closure (3), skin graft (8), Atasoy flap (8), thenar flap (4), and cross-finger flap (2). The procedures were performed on an outpatient basis under regional anesthesia.…”

Section: Methodsmentioning

confidence: 99%

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Topical Becaplermin Improves Outcomes in Work Related Fingertip Injuries

Freedman¹,

Oplinger²,

Freedman³

2005

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Topical Becaplermin Improves Outcomes in Work Related Fingertip Injuries

Freedman¹,

Oplinger²,

Freedman³

2005

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…The most frequent traumatic amputations to the upper extremity are distal to the distal interphalangeal joint [5, 22]. These seemingly mundane injuries represent a significant cost to society and to the affected individuals for treatment and from losses due to decreased production.…”

Section: Discussionmentioning

confidence: 99%

“…Trimming the bony support of the nail bed shortens the finger and increases the hook deformity. Primary closure may prevent the nail bed distraction that occurs when fingertips heal by secondary intention, and repair under tension increases the risk for cold intolerance and pulp tenderness [5, 9, 11, 19, 22, 28, 30]. …”

Section: Discussionmentioning

confidence: 99%

Digital Tip Amputations from the Perspective of the Nail

Champagne

Hustedt

Walker

et al. 2016

Advances in Orthopedics

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The management strategy proposed herein for fingertip amputations advocates secondary healing with preservation of appearance as well as function. Conservative healing is more likely to result in a sensate, nontender, and cosmetically acceptable fingertip compared to surgical management in many clinical scenarios. This manuscript examines in detail the extent of fingertip injury and defines the relationship of injury to final fingertip outcome. A classification is presented, which allows adequate initial counseling regarding prognosis, and predicts the need for secondary corrective surgery.

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“…If there is not enough soft tissue to cover the bone, the patient could suffer from the solid and sharp end of the bone while pinching. Moreover, tight closure results in flexion deformity, which may progress to finger stiffness, and cold sensitivity happens more in direct closure than grafting [15].…”

Section: Discussionmentioning

confidence: 99%

Bilateral V–Y Rotation Advancement Flap for Fingertip Amputations

Sungur¹,

Kankaya²,

Yıldız

et al. 2012

Hand (New York, N,Y.)

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Background Fingertip amputation is the most common type of injury in the upper limb. Goals in fingertip amputation reconstruction are covering the defect, establishing maximum tactile gnosis, keeping the length of the finger, protecting the joint function, acquiring a well-padded pulp tissue, providing a bed for growing nail, obtaining a satisfactory cosmetic appearance and allowing the patient to return to work as soon as possible. Adjacent skin and soft tissue are the best covers for fingertip injuries. However, local homodigital flaps lack enough tissue to cover the defect. To solve this problem, we used V-Y rotation advancement flap bilaterally in fingertip amputations which meets all the reconstruction goals. Rotation besides advancement makes this flap more mobile and easier to cover larger defects in all amputation planes. Methods Between 2007 and 2009, we performed bilateral V-Y rotation advancement flap on seven male patients' pulpa (average age, 37.6 years) whose fingertips were not replantable.Results Fourteen flaps were made on 7 fingers. There was neither total nor partial flap loss. Patients had neither cold intolerance nor scar hypersensitivity. Stiffness of the PIP joint did not occur. No obvious hooked nail occurred in patients who have remaining nail matrix. Because flaps contain neurovascular bundle, there was no difference in sensation and perfusion between the finger's pre-operative and post-operative status. The result was satisfactory with painless pinching. Conclusion In addition to the various and versatile fingertip reconstruction methods, we want to present V-Y rotation advancement flap as a quick, reliable and aesthetic method.

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Fingertip Lesions an Evaluation of Conservative Treatment Versus Free Skin Grafting

Cited by 81 publications

References 7 publications

Topical Becaplermin Improves Outcomes in Work Related Fingertip Injuries

Topical Becaplermin Improves Outcomes in Work Related Fingertip Injuries

Digital Tip Amputations from the Perspective of the Nail

Bilateral V–Y Rotation Advancement Flap for Fingertip Amputations

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