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Reconstruction and Regeneration of Composite Fingertip Injuries Using Acellular Bladder Matrix
Usman Zareef1, Anna Green2, Caroline Moore3
1Department of Orthopaedic Surgery, University of Maryland School of Medicine, Baltimore, MD.
Journal of Hand Surgery Global Online
|April 4, 2025
Summary
Acellular urinary bladder matrix (UBM) promotes fingertip regeneration in complex amputations. This regenerative approach offers excellent patient satisfaction with minimal complications, making it a viable treatment option.
Area of Science:
- Regenerative Medicine
- Biomaterials Science
- Hand Surgery
Background:
- Traumatic fingertip amputations are common emergency department injuries.
- Current management strategies for these injuries lack standardization.
- Acellular urinary bladder matrix (UBM) presents a novel therapeutic option.
Purpose of the Study:
- To evaluate the efficacy of acellular urinary bladder matrix (UBM) in complex distal fingertip injuries.
- To assess fingertip regeneration and patient outcomes following UBM application.
- To determine the safety and reliability of UBM for fingertip reconstruction.
Main Methods:
- A prospective cohort study involving 47 patients with proximal fingertip amputations (Allen zones III and IV).
- UBM was applied initially in the operating room, with subsequent weekly applications until granulation tissue formed.
- Patients managed daily dressing changes, with an average of 2.5 UBM applications per patient.
Main Results:
- Fingertip regeneration was achieved in an average of 8.4 weeks.
- Mean length deficits were 3.6 mm (zone 3) and 4.8 mm (zone 4).
- High patient satisfaction (9.5/10) was reported, with minor complications including hook nail deformities and one bony exostosis.
Conclusions:
- UBM is a reliable method for promoting composite regeneration in Allen zone III-IV fingertip injuries.
- The treatment yields excellent patient satisfaction and a low complication rate.
- Urinary bladder matrix is a promising therapeutic consideration for proximal fingertip amputations.
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