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Outcome Scores for Fingertip Injuries: A Systematic Review.

J Terrence Jose Jerome1, G Surendran2, Thirumagal Kuppusamy3

  • 1Department of Orthopedics, Dhanalakshmi Srinivasan Medical College, Hospital, Siruvachur, Perambalur, Tamilnadu, India.

JBJS Reviews
|November 14, 2025
PubMed
Summary
This summary is machine-generated.

The Fingertip Injuries Outcome Score (FIOS) is the only instrument specifically designed for fingertip injuries, offering a comprehensive assessment. This review recommends adopting FIOS as the primary standard for reporting outcomes in fingertip injuries.

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Area of Science:

  • Orthopedics and Sports Medicine
  • Hand Surgery
  • Rehabilitation Medicine

Background:

  • Fingertip injuries often result in varied outcomes influenced by physical and psychosocial factors.
  • Existing general outcome measures (e.g., DASH, MHQ, PROMIS) lack specificity for fingertip concerns like nail deformity or cold intolerance.
  • The Fingertip Injuries Outcome Score (FIOS) was developed to address this gap by integrating objective and patient-reported domains.

Purpose of the Study:

  • To systematically review and evaluate existing outcome scoring systems for fingertip injuries.
  • To assess the validity, reliability, responsiveness, and clinical utility of these instruments, with a focus on the FIOS.
  • To determine the most appropriate instrument for fingertip injury outcome assessment and reporting.

Main Methods:

  • A systematic literature search was conducted across PubMed, Scopus, and Web of Science up to December 2024.
  • Studies evaluating fingertip injuries using defined outcome scores were identified.
  • Data extracted included score domains, psychometric properties, and clinical applicability.

Main Results:

  • The FIOS was the sole fingertip-specific score identified, showing strong internal consistency (Cronbach α = 0.796) and excellent interrater reliability (κ = 0.844).
  • General PROMs (MHQ, DASH, PROMIS) demonstrated high internal consistency but lacked fingertip-specific coverage.
  • The FIOS integrates objective measures (grip strength, 2PD) and patient-reported outcomes (nail esthetics, sensibility), making it the most specific assessment available.

Conclusions:

  • The FIOS is the most comprehensive instrument for fingertip-specific outcomes and should be the primary standard for reporting.
  • Combining FIOS with general hand PROMs and objective tests ensures a thorough assessment.
  • Standardizing on FIOS will harmonize reporting, facilitate comparisons across studies, and improve long-term follow-up for fingertip injuries.