Comparison of Outcomes of Three Different Modalities for Treatment of Acute Fingertip Injuries
Treatment of Acute Fingertip Injuries
DOI:
https://doi.org/10.54393/pjhs.v4i06.754Keywords:
Acute Fingertip Injuries, Treatment, CISS QuestionnaireAbstract
The fingertip has a crucial role in providing tactile and sensory functions to the brain. Anatomically, it refers to the region behind the extensor tendons and point of insertion of the flexor digitorum superficialis at the distal phalanx or interphalangeal joint in the case of the thumb. Objective: To compare the outcomes of three different modalities for managing acute fingertip injuries involving healing by secondary intention, primary closure, and local flap coverage. Methods: A randomized control trial was conducted, employing non-probability consecutive sampling. The inclusion criteria consisted of patients aged 20 to 40 years with fingertip injuries and tissue loss categorized as Allen II, III, or IV injuries. Cold intolerance was assessed using the Cold Intolerance Severity Symptom (CISS) questionnaire, which assigns a score ranging from 0 to 100. The sensibility of the injured and uninjured fingers was evaluated using the Semmes-Weinstein monofilament test (SWF). The chi-square test was used to examine relevant relationships. Results: Statistically significant associations were observed between smoking, comorbidities, and treatment modalities (p < 0.001). Among smokers, 81% received Group A treatment, while only 38% of smoking patients were treated with Group B and 69% with Group C. In the Group A treatment, 54.8% of patients were left-handed, 57.1% had Allen III classification, 54.8% had transverse injuries, and only 8% experienced short-term complications (infection). Conclusions: Based on the study findings, no significant differences were identified among the three treatment modalities.
References
Binstead JT, Tafti D, Hatcher JD. Boutonniere Deformity. StatPearls: StatPearls Publishing; 2022.
Weir Y. Fingertip injuries in children: a review of the literature. Emergency Nurse. 2022 Jul; 30(4): 1.
Cerny MK, Moog P, Bauer AT, Schmauss D, Varga L, Aitzetmueller MM, . Lipofilling of fingertips for volume defects after fingertip injuries. Annals of Plastic Surgery. 2018 Dec; 81(6): 653-6. doi: 10.1097/SAP.0000000000001587. DOI: https://doi.org/10.1097/SAP.0000000000001587
Bjorklund KA, Rice DM, Amalfi AN. Pediatric digital necrosis secondary to dressing application: a case series. Hand. 2018 Jul; 13(4): NP14-6. doi: 10.1177/1558944718772387. DOI: https://doi.org/10.1177/1558944718772387
Yorlets RR, Busa K, Eberlin KR, Raisolsadat MA, Bae DS, Waters PM, et al. Fingertip injuries in children: epidemiology, financial burden, and implications for prevention. Hand. 2017 Jul; 12(4): 342-7. doi: 10.1177/1558944716670139. DOI: https://doi.org/10.1177/1558944716670139
Ramponi DR, Ramirez EG, Hoyt KS. Management of hand injuries: Part II. Advanced Emergency Nursing Journal. 2016 Oct; 38(4): 266-78. doi: 10.1097/TME.0000000000000128. DOI: https://doi.org/10.1097/TME.0000000000000128
Sullivan MA, Cogan CJ, Adkinson JM. Pediatric hand injuries. Plastic and Aesthetic Nursing. 2016 Jul; 36(3): 114-20. doi: 10.1097/PSN.0000000000000145. DOI: https://doi.org/10.1097/PSN.0000000000000145
Peterson SL, Peterson EL, Wheatley MJ. Management of fingertip amputations. Journal of Hand Surgery. 2014 Oct; 39(10): 2093-101. doi: 10.1016/j.jhsa.2014.04.025. DOI: https://doi.org/10.1016/j.jhsa.2014.04.025
George A, Alexander R, Manju C. Management of nail bed injuries associated with fingertip injuries. Indian Journal of Orthopaedics. 2017 Dec; 51: 709-13. doi: 10.4103/ortho.IJOrtho_231_16. DOI: https://doi.org/10.4103/ortho.IJOrtho_231_16
Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip injuries and amputations: a review of the literature. Cureus. 2020 May; 12(5): 1-6. doi: 10.7759/cureus.8291. DOI: https://doi.org/10.7759/cureus.8291
Chang J, Vernadakis AJ, McClellan WT. Fingertip injuries. Clinics in Occupational and Environmental Medicine. 2006 Jan; 5(2): 413-22.
van den Berg WB, Vergeer RA, van der Sluis CK, Ten Duis HJ, Werker PM. Comparison of three types of treatment modalities on the outcome of fingertip injuries. Journal of Trauma and Acute Care Surgery. 2012 Jun; 72(6): 1681-7. doi: 10.1097/TA.0b013e318248bc8c. DOI: https://doi.org/10.1097/TA.0b013e318248bc8c
Afrăsânie VA, Adavidoaiei AM, Zamisnicu IH, Funingănă IG, Marinca MV, Gafton B, et al. A very rare presentation of lung cancer: Metastases to the distal phalanx of index–case report. Medicine. 2019 Dec; 98(49): e17892. doi: 10.1097/MD.0000000000017892. DOI: https://doi.org/10.1097/MD.0000000000017892
Evans DM and Bernadis C. A new classification for fingertip injuries. Journal of Hand Surgery. 2000 Feb; 25(1): 58-60. doi: 10.1054/jhsb.1999.0305. DOI: https://doi.org/10.1054/jhsb.1999.0305
RH J. An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation. 1969 Jun; 50(6): 311-9.
Hattori Y, Doi K, Ikeda K, Estrella EP. A retrospective study of functional outcomes after successful replantation versus amputation closure for single fingertip amputations. The Journal of Hand Surgery. 2006 May; 31(5): 811-8. doi: 10.1016/j.jhsa.2006.02.020. DOI: https://doi.org/10.1016/j.jhsa.2006.02.020
Ma GF, Cheng JC, Chan KT, Chan KM, Leung PC. Finger tip injuries--a prospective study on seven methods of treatment on 200 cases. Annals of the Academy of Medicine, Singapore. 1982 Apr; 11(2): 207-13. doi:
Martin C and del Pino JG. Controversies in the treatment of fingertip amputations: conservative versus surgical reconstruction. Clinical Orthopaedics and Related Research®. 1998 Aug; 353: 63-73. doi: 10.1097/00003086-199808000-00008. DOI: https://doi.org/10.1097/00003086-199808000-00008
Lee LP, Lau PY, Chan CW. A simple and efficient treatment for fingertip injuries. Journal of Hand Surgery. 1995 Feb; 20(1): 63-71. doi: 10.1016/S0266-7681(05)80019-1. DOI: https://doi.org/10.1016/S0266-7681(05)80019-1
Mennen U and Wiese A. Fingertip injuries management with semiocclusive dressing. Journal of Hand Surgery. 1993 Aug; 18(4): 416-22. doi: 10.1016/0266-7681(93)90139-7. DOI: https://doi.org/10.1016/0266-7681(93)90139-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments