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Fingertip Injury and Management.
Nicholas S Golinvaux1, Jed I Maslow1, James P Hovis1
1Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
JBJS Essential Surgical Techniques
|February 6, 2020
Summary
Managing fingertip injuries requires understanding unique anatomy for optimal outcomes. This study reviews surgical techniques to preserve digit function, length, and sensation, minimizing complications like nail deformity.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Trauma Management
Background:
- Fingertip injuries are prevalent and pose management challenges due to complex anatomy.
- Effective treatment aims to restore function, sensation, and digit length while minimizing pain.
Purpose of the Study:
- To review and demonstrate various surgical treatment options for diverse fingertip injuries.
- To emphasize the importance of anatomical knowledge in selecting optimal management strategies.
Main Methods:
- Review of surgical techniques for fingertip reconstruction.
- Demonstration of local and regional flap reconstruction.
- Discussion of revision/completion amputation, nail bed repair, dermal regeneration templating, and replantation.
Main Results:
- Treatment selection depends on injury type, location, soft-tissue loss, and nail bed involvement.
- Outcomes are generally favorable but influenced by injury and patient factors.
- Common complications include nail deformity, cold intolerance, and neuroma formation.
Conclusions:
- A thorough understanding of fingertip anatomy is crucial for successful surgical management.
- Multiple reconstructive options exist, tailored to specific injury characteristics.
- Careful surgical planning can mitigate common post-operative complications.
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