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Fingertip Amputation

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1. Analysis of the risk factors that determine composite graft survival for fingertip amputation. (Abstract)

Analysis of the risk factors that determine composite graft survival for fingertip amputation. The composite graft is the only surgical method that is able to maintain digital length and provide soft tissue coverage without donor site morbidities in microsurgically non-replantable fingertip amputations. This study aimed to explore the risk factors that determine the survival of composite grafts. Clinical characteristics associated with graft survival were retrospectively analysed (...) by a comparison between the graft survival and failure groups. Of 94 patients who underwent a composite graft for fingertip amputation, the graft survived in 84 (89%). Surviving grafts showed reperfusion within 1 week. Multivariate analysis revealed that graft failure was independently associated with a crushing injury. Based on the risk factors from the comparison analyses and a review of previously published studies, a cutting injury, grafting the injured finger within 5 hours of injury, and being a non

2018 Journal of Hand Surgery - European

2. Composite Grafts for Pediatric Fingertip Amputations: A Retrospective Case Series of 100 Patients Full Text available with Trip Pro

Composite Grafts for Pediatric Fingertip Amputations: A Retrospective Case Series of 100 Patients Fingertip amputations are common. This study reports on the outcomes of composite grafts used for fingertip amputations in children, measuring graft take, predictors of graft take, complications, and patient-reported outcomes.A retrospective case series of consecutive patients (≤ 16 years) undergoing composite grafts for fingertip amputations in a tertiary pediatric hospital, January 06 to December (...) 16, was performed. Information was collected on amputations, graft take, and complications. Logistic regression was used to analyze factors predicting graft take (partial/complete or failure) including age; amputation level; mechanism and time delay to surgery. Patients were contacted via post or telephone to ask about functional and cosmetic outcomes and their perception of graft take.One hundred patients [57 (57%) males; mean age, 4.41 ± 3.98 years], presenting with 100 fingertip amputations

2018 Plastic and Reconstructive Surgery Global Open

3. Study protocol for a randomized controlled pilot-trial on the semiocclusive treatment of fingertip amputation injuries using a novel finger cap. Full Text available with Trip Pro

Study protocol for a randomized controlled pilot-trial on the semiocclusive treatment of fingertip amputation injuries using a novel finger cap. Fingertip amputation injuries are common in all ages. Conservatively treated fingertips can regenerate skin and soft tissues to form a functionally and cosmetically excellent new fingertip. Little is known about this ability that, in humans, is confined to the fingertips. Even less is known about the role of the bacteria that regularly colonize (...) , which can be thus routinely analyzed for diagnostic and research purposes.This study protocol explains the first randomized controlled trial (RCT) on the semiocclusive treatment of fingertip amputations in both children and adults comparing traditional film dressings with the novel silicone finger cap. Being the first RCT using 2 medical devices not yet certified for this indication, it will gather valuable information for the understanding of fingertip regeneration and the design of future

2017 Medicine Controlled trial quality: uncertain

4. Management of partial fingertip amputation in adults: Operative and non operative treatment. (Abstract)

Management of partial fingertip amputation in adults: Operative and non operative treatment. Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries (...) to articles published within the past 15 years.In the United States, up to 90% of fingertip amputations are treated with non-replant techniques. In comparison, the majority of amputations in Asian countries are replanted due to moral values and importance of body integrity. Tip amputation injuries can be managed with local debridement, complex reconstruction, or simply with irrigation and application of a sterile dressing.In the United States, most fingertip amputations in adults are treated with non

2017 Injury

5. A case of dorsal oblique fingertip amputation Full Text available with Trip Pro

A case of dorsal oblique fingertip amputation This study reports successful finger replantation in a patient with a dorsal oblique fingertip amputation. When repairing this unique type of injury, an evaluation of the remaining vessels is more useful for successful replantation than the anatomical zone classification. We propose that Kasai's classification is appropriate for guiding treatment.

2017 Case Reports in Plastic Surgery & Hand Surgery

6. Reconstruction of Severely Crushed Fingertip Amputations with Basic Fibroblast Growth Factor Slow Release System Full Text available with Trip Pro

Reconstruction of Severely Crushed Fingertip Amputations with Basic Fibroblast Growth Factor Slow Release System Supplemental Digital Content is available in the text.

2017 Plastic and Reconstructive Surgery Global Open

7. The Double Thenar Flap: A Technique to Reconstruct 2 Fingertip Amputations Simultaneously. (Abstract)

The Double Thenar Flap: A Technique to Reconstruct 2 Fingertip Amputations Simultaneously. Fingertip injuries are a common problem. There may be pulp loss and exposed bone. Various techniques have been described to reconstruct function as well as aesthetics; yet it is still unclear which treatment options should be chosen for each specific injury. Evidence-based treatment strategies are limited because there are no prospective randomized clinical trials evaluating one method with another (...) . Fingertip injuries are usually variable in their presentation, and therefore treatment decisions are often dictated by the knowledge and expertise of the treating physician combined with the patient's unique injury. With exposed bone and major distal soft tissue loss, many reconstructive techniques have been well-described including local advancement flaps, thenar flaps, and cross-finger flaps. There is scarce literature discussing surgical options when multiple fingers are involved. This report details

2017 Journal of Hand Surgery - American

8. Fingertip Amputation

Fingertip Amputation Fingertip Amputation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fingertip Amputation Fingertip Amputation (...) Aka: Fingertip Amputation , Finger Tip Amputation From Related Chapters II. Classification Zone I Fingertip Amputation Preserved distal phalanx without bone exposure Majority of nail bed and nail matrix intact Zone II Fingertip Amputation Amputation distal to lunula of nail bed Bony exposure of distal phalanx Zone III Fingertip Amputation Loss of entire nail bed Large portion of distal phalanx lost III. Precautions See Set expectations at time of initial presentation Affected finger may heal

2018 FP Notebook

9. Fingertip Amputation Repair

Fingertip Amputation Repair Fingertip Amputation Repair Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fingertip Amputation Repair (...) Fingertip Amputation Repair Aka: Fingertip Amputation Repair , V-Y Plasty II. Indications: Fingertip Amputation Dorsal Plane Zone II More finger nail avulsed than pulp Transverse Plane Zone II Equivalent amounts of finger nail avulsed as pulp III. Contraindications Volar Plane Zone II More fingertip pulp avulsed than finger nail IV. Efficacy Preserves finger tip padding and contour Most patients re-establish Good cosmetic result with minimal scar V. Technique: Step 1 Preparation Anesthesia with Elevate

2018 FP Notebook

10. Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap Full Text available with Trip Pro

Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap Background: The goals of fingertip reconstruction are to achieve adequate soft-tissue coverage and a functional nail plate and to maintain sensation, proprioception, and cosmesis. Objective: We present a composite tissue graft and volar V-Y advancement flap for reconstruction of a traumatic amputation of a fingertip, which (...) provided optimal preservation of the hyponychium and the volar pad for prevention of a hook nail. Historically, composite fingertip grafts have not been recommended for adults with large defects. Methods: The amputated nail bed, hyponychium, and a 10 × 20-mm segment of the fingertip were utilized as a composite graft for reconstruction of the nail bed in an adult. The addition of a volar V-Y advancement flap to reconstruct the fingertip was necessary for complete soft-tissue reconstruction. Results

2017 Eplasty

11. Decellularized Matrix and Supplemental Fat Grafting Leads to Regeneration following Traumatic Fingertip Amputation Full Text available with Trip Pro

Decellularized Matrix and Supplemental Fat Grafting Leads to Regeneration following Traumatic Fingertip Amputation Decellularized scaffold materials are capable of regenerating missing tissues when utilized under appropriate conditions. Fat grafting also has reported advantages in revitalizing damaged tissue beds. This report details a case of traumatic fingertip amputation treated with a combination of decellularized materials in conjunction with fat grafting, resulting in a supple (...) and functional reconstruction of the affected digit. After traumatic fingertip amputation, a patient was initially treated with decellularized porcine urinary bladder matrix powder. As a second stage, the healed tip scar tissue was reexcised, and a second application of powder was applied. As a third stage, the tip scar tissue was reexcised and a decellularized bilayer was sewn into the soft tissues of the debrided tip, resulting in an improved soft tissue envelope. As a final stage, the restored fingertip

2016 Plastic and Reconstructive Surgery Global Open

12. Reconstruction of two fingertip amputations using a double thenar flap and comparison of outcomes of surgery using a single thenar flap. (Abstract)

Reconstruction of two fingertip amputations using a double thenar flap and comparison of outcomes of surgery using a single thenar flap. Although thenar flap for single fingertip amputation is a common and popular surgical technique, double thenar flap technique for patients with two fingertip amputations has rarely been reported in the literature. The purpose of this case-control study was to introduce the double thenar technique and compare the clinical outcomes between single thenar flap (...) and double thenar flap surgical treatments.From January 2005 to December 2014, 92 patients with single fingertip amputations were treated with thenar flap (Group I) and 28 patients with two fingertip amputations were treated with double thenar flap (Group II). These 120 patients were followed-up for a minimum of 12 months postoperatively. At the latest follow-up, the two groups were assessed for pain, cold intolerance in the reconstructed finger, functional outcomes by Chen's criteria, and subjective

2016 Injury

13. Evaluation of Result and Influence Factors on Composite Graft in Fingertip Amputation

structure, achieving a well-contoured and painless fingertip, and restoring durable and sensate skin. There are so many factor that influence the result of composite graft in distal finger tip amputation. Investigators will collected the data including the size of amputee , shape, level of amputation, mechanism of amputation, if hyperbaric oxygen therapy, operation procedures. Condition or disease Pinprick Sensation Diminished Amputation, Traumatic Pain Detailed Description: Fingertip amputations (...) Evaluation of Result and Influence Factors on Composite Graft in Fingertip Amputation Evaluation of Result and Influence Factors on Composite Graft in Fingertip Amputation - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2015 Clinical Trials

14. The use of prophylactic antibiotic in treatment of fingertip amputation: a randomized prospective trial. (Abstract)

The use of prophylactic antibiotic in treatment of fingertip amputation: a randomized prospective trial. Fingertip amputation is a common injury. Considerable controversy exists as to whether prophylactic antibiotics are necessary for this injury. Our goal was to compare the rate of infections among subgroups with and without prophylactic antibiotic treatment. The study hypothesis was that infection rates were similar in the 2 groups.This was a prospective randomized control trial of adult (...) patients presenting with fingertip amputation with bone exposed, requiring surgical treatment. Patients were randomized to 2 groups: group 1 received no antibiotics, and group 2 received 1 g intravenous antibiotics (cefazolin) for 3 days. The 2 groups were matched for age, time to surgery, injury mechanism, and type of surgery. All surgical treatments were performed in the operating room, and all patients were reevaluated in our outpatient clinic after 10 days and again after a month. The primary

2015 American Journal of Emergency Medicine Controlled trial quality: uncertain

15. Aesthetic and functional results from nailfold recession following fingertip amputations. (Abstract)

Aesthetic and functional results from nailfold recession following fingertip amputations. To analyze the aesthetic and functional results of a technique for nail salvage by recessing the nailfold to increase the exposed nail matrix after fingertip amputation.Thirty cases of fingertip amputation with distal partial nail bed defects underwent nailfold recession and pulp reconstruction. We increased nail bed exposure by recessing a rectangle flap of eponychium and reconstructed the pulp (...) and pulp and no deformities. The sensation and mobility of injured and uninjured contralateral fingers did not differ statistically. All patients were satisfied with the appearance and function of the reconstructed fingertips.Nailfold recession combined with different local flaps provided for the aesthetic and functional restoration of the fingertip after amputation with partial nail bed defect.Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

2015 Journal of Hand Surgery - American

16. Conservative treatment of fingertip injuries in children – first experiences with a novel silicone finger cap that enables woundfluid analysis Full Text available with Trip Pro

Conservative treatment of fingertip injuries in children – first experiences with a novel silicone finger cap that enables woundfluid analysis Introduction: Human fingertips are able to regenerate soft tissue and skin after amputation injuries with excellent cosmetic and functional results when treated with semiocclusive dressings. Despite bacterial colonizations, proceeding infections are not reported with this management. The underlying mechanisms for this form of regenerative healing (...) with traumatic fingertip amputations primarily treated with occlusive dressings. 12 patients were treated with a novel silicone finger cap. We summarized clinical data for each patient. This included photographs and microbiological results from wound fluid analyses, whenever available. Results: The results of both, conventional film dressing and silicone finger cap treatment, were excellent with no hypersensitivity and no restrictions in sensibility and motility. Even larger pulp defects were rearranged

2018 GMS Interdisciplinary plastic and reconstructive surgery DGPW

17. The fate of delayed revascularization for neglected vascular injury of incompletely amputated digits and hands. (Abstract)

The fate of delayed revascularization for neglected vascular injury of incompletely amputated digits and hands. We report the fate of neglected vascular injury in cases of incomplete amputation of the digits and hand after delayed revascularization. Twelve patients underwent primary bone fixation, tendon or skin repair for hand injuries without vessel repair despite ischaemic findings. There was discoloration or necrosis of the fingertips during follow-up examination and the patients were (...) referred to us for treatment. The mean warm ischaemic time was 53 hours (range 17-120). Delayed revascularization was performed with end-to-end anastomosis of the digital arteries in eight and vein graft in four cases. Digital nerves were repaired in four cases and flexor tendons in two cases. Of the 12 cases, eight cases showed complete survival. However, in four patients, complete necrosis of the fingers occurred, with one finger surviving partially. Revision amputation was performed in the four

2019 Journal of Hand Surgery - European

18. Intraneural stimulation elicits discrimination of textural features by artificial fingertip in intact and amputee humans Full Text available with Trip Pro

Intraneural stimulation elicits discrimination of textural features by artificial fingertip in intact and amputee humans Restoration of touch after hand amputation is a desirable feature of ideal prostheses. Here, we show that texture discrimination can be artificially provided in human subjects by implementing a neuromorphic real-time mechano-neuro-transduction (MNT), which emulates to some extent the firing dynamics of SA1 cutaneous afferents. The MNT process was used to modulate the temporal (...) pattern of electrical spikes delivered to the human median nerve via percutaneous microstimulation in four intact subjects and via implanted intrafascicular stimulation in one transradial amputee. Both approaches allowed the subjects to reliably discriminate spatial coarseness of surfaces as confirmed also by a hybrid neural model of the median nerve. Moreover, MNT-evoked EEG activity showed physiologically plausible responses that were superimposable in time and topography to the ones elicited

2016 eLife

19. Interventions for treating fingertip entrapment injuries in children. Full Text available with Trip Pro

to 16.37). Both participants with infections had a more severe injury (partial fingertip amputation).The other trial compared two different dressings (silicone net and paraffin gauze) for use after either surgical or initial conservative management of fingertip entrapment injuries. It reported that two of 20 children in the silicone group versus one of 25 in the paraffin group had complications of wound infection (RR 2.50, 95% CI 0.24 to 25.63) and that one of 20 children in the silicone group versus (...) Interventions for treating fingertip entrapment injuries in children. Fingertip entrapment injuries, which involve lacerations to the pulp and nail and often a fracture of the underlying bone, commonly occur in children, usually as the result of a crushing injury. Treatment is either conservative (wound cleaning and fingertip dressing)or surgical (repair of lacerations, reduction and stabilisation of fractures); however, no consensus currently exists regarding the most appropriate treatment

2014 Cochrane

20. A prospective randomised comparison of fixation methods in Tamai's zone I amputation. (Abstract)

A prospective randomised comparison of fixation methods in Tamai's zone I amputation. The treatment of choice for fingertip amputation is replantation to restore function and aesthetics. The purpose of this study was to compare the success rates and salvage periods between patients with Tamai's zone I amputation injuries treated with bony fixation and suture fixation.Fifty-five patients with Tamai's zone I amputations with bony involvement were included in this study. The patients were (...) allocated randomly to two groups treated by bony fixation with Kirschner (K-)wire and suture fixation, respectively. In the bony fixation group (n = 21), the distal phalangeal bone was fixed with K-wire; in the suture fixation group (n = 34), the amputated portion was fixed with sutures alone. The success rate was defined as the percentage of fully viable replanted cases, and the salvage period was defined as extending from the first postoperative day to the cessation of salvation.The success rates

2018 Journal of plastic, reconstructive & aesthetic surgery : JPRAS Controlled trial quality: uncertain

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