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of unilateral upper limb amputees and individuals with all limbs intact to temporally based sensory tactile testing of the fingertips to test the hypothesis that changes in sensory perception also have an effect on the intact limb. Upper extremity amputees were assessed for the presence of referred sensations (RSs)-experiencing feelings in the missing limb when a different body region is stimulated, to determine changes within the brain that occur due to an amputation. Eight of 19 amputees (42.1 (...) Hand-to-Face Remapping But No Differences in Temporal Discrimination Observed on the Intact Hand Following Unilateral Upper Limb Amputation Unilateral major limb amputation causes changes in sensory perception. Changes may occur within not only the residual limb but also the intact limb as well as the brain. We tested the hypothesis that limb amputation may result in the detection of hand sensation during stimulation of a non-limb-related body region. We further investigated the responses
Randomized controlled trial of the application of topical b-FGF-impregnated gelatin microspheres to improve tissue survival in subzone II fingertipamputations. We undertook a randomized controlled trial of subzone II fingertipamputations, comparing standard treatment with topical application of gelatin microspheres prepared with basic fibroblast growth factor (b-FGF) to provide a slow, sustained release of b-FGF with microsphere degradation. Forty-eight digits from 42 patients were randomized (...) and composite grafted fingertips, though this did not achieve statistical significance. Whether the slow release of b-FGF through a bioresorbable carrier gives any improvement in outcome in patients with subzone II fingertipamputations is unproven.
Kutler repair for amputatedfingertip 19310702 2010 06 25 2010 06 25 0035-8843 61 6 1979 Nov Annals of the Royal College of Surgeons of England Ann R Coll Surg Engl Kutler repair for amputatedfingertip. 485 Crockett J E JE eng Journal Article England Ann R Coll Surg Engl 7506860 0035-8843 2009 3 25 9 0 1979 11 1 0 0 1979 11 1 0 1 ppublish 19310702 PMC2492254
Kutler repair for the amputatedfingertip. Fingertipamputation is a common injury. Although the damage may not be extensive, the disability produced can be considerable. Different surgical procedures are available for reconstruction, but none is absolutely satisfactory. Twenty-four cases of fingertipamputation have been treated by primary skin closure using the Kutler bilateral V-Y advancement technique. The procedure was found to be simple and satisfactory, both functionally and cosmetically.
Digital Tip Amputations from the Perspective of the Nail The management strategy proposed herein for fingertipamputations advocates secondary healing with preservation of appearance as well as function. Conservative healing is more likely to result in a sensate, nontender, and cosmetically acceptable fingertip compared to surgical management in many clinical scenarios. This manuscript examines in detail the extent of fingertip injury and defines the relationship of injury to final fingertip
survived entirely and restored a rounded fingertip contour. Mean static 2-point discrimination was 5 mm (range, 4-6 mm). With the exception of 1 patient with an amputation at the distal interphalangeal joint, the distal interphalangeal joint was preserved in all patients and had 30° to 60° of motion at final follow-up. No patients complained of cold intolerance or residual joint contracture. No hooked nail deformity occurred in patients who had remaining nailbed.The digital artery perforator propeller (...) Innervated Digital Artery Perforator Propeller Flap for Reconstruction of Lateral Oblique Fingertip Defects. To report our experience with the use of a digital artery perforator propeller flap based on a constant distal perforator in the middle phalanx for resurfacing of lateral oblique fingertip amputations.Twelve fingertips in 10 patients underwent reconstruction, with a mean follow-up of 8 months (range, 8-12 mo). The size of the flaps ranged from 2.5 × 1.5 cm to 3.0 × 2.0 cm.All flaps
for the treatment of fingertipamputation, which can produce better sensation and functional outcomes than skin graft transplantations. (...) A novel use of amniotic membrane for fingertip injuries. Fingertip injuries, which are the most common hand injury, represent management challenges for hand surgeons. Full thickness skin grafts are routinely used to cover the fingertip site, but has significant donor site morbidity. As amniotic membranes (AM) are used as a dressing substitute in burns, we decided to evaluate the efficacy of AM as a biologic wound dressing material for coverage of these injuries.In this clinical study, 30
deformities. When amputation with loss of two thirds of the nail occurs, half of the fingers develop beaking or a curved nail. Previous Next: Prognosis Oldest recorded patient to show fingertip regeneration was aged 11 years. Previous Next: Patient Education Full growth of nail takes an average of 100 days, but fingertip trauma may delay growth by 20 days. Average healing time for fingertipamputation is 21-27 days. Remove sutures after 7-10 days. For excellent patient education resources, visit (...) with an intravenous dressing. J Wound Care . 2015 Jun. 24 (6):276, 278-9. . Gellman H. Fingertip-nail bed injuries in children: current concepts and controversies of treatment. J Craniofac Surg . 2009 Jul. 20(4):1033-5. . Li J, Guo Z, Zhu Q, Lei W, Han Y, Li M. Fingertip replantation: determinants of survival. Plast Reconstr Surg . 2008 Sep. 122(3):833-9. . Zhou X, Xu Y, Rui Y, Yao Q. [Investigation of new classification and repair methods for fingertip traverse amputation]. Zhongguo Xiu Fu Chong Jian Wai Ke Za
== processing > Fingertip Injuries Treatment & Management Updated: Sep 23, 2015 Author: Glen Vaughn, MD; Chief Editor: Trevor John Mills, MD, MPH Share Email Print Feedback Close Sections Sections Fingertip Injuries Treatment Prehospital Care Care for amputated part Cleanse gently. Cover in a saline-soaked gauze wrap. Place amputated part in a watertight bag. Place watertight bag with amputated part on water and ice for preservation. To avoid cold injury, do not place the amputated part directly on ice (...) to skin fold or nail disruption. [ ] Conservative treatment also is indicated for crush injuries that fracture the terminal phalanx but do not cause a subungual hematoma. Fingertipamputations Treatment is either surgical or conservative. The boundary between surgical and conservative treatment depends on the extent of involvement of the pulp, nail, and bone. Various surgical methods are used for amputation injuries including simple revision amputation, full- or partial-thickness skin grafts, local
of survival. Plast Reconstr Surg . 2008 Sep. 122(3):833-9. . Zhou X, Xu Y, Rui Y, Yao Q. [Investigation of new classification and repair methods for fingertip traverse amputation]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi . 2008 Sep. 22(9):1089-91. . Zhang X, Shao X, Ren C, Zhang Z, Wen S, Sun J. Reconstruction of thumb pulp defects using a modified kite flap. J Hand Surg Am . 2011 Oct. 36(10):1597-603. . Eberlin KR, Busa K, Bae DS, Waters PM, Labow BI, Taghinia AH. Composite grafting for pediatric (...) fingertip injuries. Hand (N Y) . 2015 Mar. 10 (1):28-33. . Peterson SL, Peterson EL, Wheatley MJ. Management of fingertipamputations. J Hand Surg Am . 2014 Oct. 39 (10):2093-101. . Muck AE, Bebarta VS, Borys DJ, Morgan DL. Six years of epinephrine digital injections: absence of significant local or systemic effects. Ann Emerg Med . 2010 Sep. 56(3):270-4. . Rubin G, Orbach H, Rinott M, Wolovelsky A, Rozen N. The use of prophylactic antibiotics in treatment of fingertipamputation: a randomized
. 2008 Sep. 122(3):833-9. . Zhou X, Xu Y, Rui Y, Yao Q. [Investigation of new classification and repair methods for fingertip traverse amputation]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi . 2008 Sep. 22(9):1089-91. . Zhang X, Shao X, Ren C, Zhang Z, Wen S, Sun J. Reconstruction of thumb pulp defects using a modified kite flap. J Hand Surg Am . 2011 Oct. 36(10):1597-603. . Eberlin KR, Busa K, Bae DS, Waters PM, Labow BI, Taghinia AH. Composite grafting for pediatric fingertip injuries. Hand (N Y (...) ) . 2015 Mar. 10 (1):28-33. . Peterson SL, Peterson EL, Wheatley MJ. Management of fingertipamputations. J Hand Surg Am . 2014 Oct. 39 (10):2093-101. . Muck AE, Bebarta VS, Borys DJ, Morgan DL. Six years of epinephrine digital injections: absence of significant local or systemic effects. Ann Emerg Med . 2010 Sep. 56(3):270-4. . Rubin G, Orbach H, Rinott M, Wolovelsky A, Rozen N. The use of prophylactic antibiotics in treatment of fingertipamputation: a randomized prospective trial. Am J Emerg Med
Fingertip replantation: Technical considerations and outcome analysis of 24 consecutive fingertip replantations Fingertipamputations are one of the most common injuries faced in an emergency department. Finger tip replantation though technically possible, are not regularly done due to the presumed complexity of the procedure and doubts about the outcome. This article deals with our experience of 24 fingertip replantations in 24 patients done over a period of 8 years since the year 2000. Twenty (...) -one fingertips survived. The most common affected digit in the series was thumb followed by index, middle, and ring. The overall success rate was 87%. Both arterial and venous repair were done in all cases. Replantation was not done if no suitable vein was found for anastomosis. Nine patients did not have nerve repair. Seven of them survived and all of them had satisfactory sensation when examined after 1 year. No patient suffered from cold intolerance. All patients were satisfied
The outcomes of digital tip amputation replacement as a composite graft in a paediatric population. Limited studies exist on the outcome of replacing an amputatedfingertip as a composite graft. We report the outcomes and predictors for composite graft survival along with the long-term morbidity. A retrospective review of all patients <16 years who underwent composite graft replacement of an amputatedfingertip was performed. Long-term morbidity was evaluated through a standardized parental
Combined Subdermal Pocket Procedure and Abdominal Flap for Distal Finger Amputations in a Toddler A girl (aged 1 year and 9 months) sustained traumatic amputation to her middle and ring fingers (zone 1C) by a cup-sealing machine. Full-thickness dorsal skin burn over amputatedfingertips was also noted. Emergent finger replantation was performed. Following bone fixation, bilateral digital arteries and nerves were repaired. After complete debridement of the necrotic dorsal skin, the extensor
Artery-only fingertip replantations using a controlled nailbed bleeding protocol. We report our experience, treatment protocol, and 2-year follow-up results of 24 fingertip replantations treated using the artery-only technique without vein or nerve repair.We performed a retrospective review of 24 patients who had undergone fingertip replantation at the same center between 2005 and 2011. All patients in this study had complete fingertipamputation at or distal to the distal interphalangeal joint (...) of the fingers or interphalangeal joint of the thumb. Patients with incomplete and complete amputations who had undergone vein and/or nerve repair along with artery repair were excluded. All patients received the same protocol including removal of the nail at the surgery and intravenous heparin 70 U/kg administered at the time of arterial anastomosis. After surgery, the nailbed was mechanically made to bleed with a sterile needle and mechanically scrubbed with a heparin-saline gauze. All patients received
Fingertip replantation at the eponychial level with venous anastomosis: an anatomic study and clinical application. We present an anatomic study of the vein distribution at the eponychial level, in order to standardize outpatient fingertip replantation. The cross sectional anatomy of 100 fingers was studied by dissection following dye injection. The distribution of the veins >0.3 mm was recorded on a pie-chart. Thirty fingers in 27 patients with fingertipamputations at the eponychial level (...) were replanted by anastomosis of the palmar subcutaneous veins, to reconstruct the venous reflux of the amputated digits. The operations were aided by the anatomical study and confirmed that the palmar area is the preferred site for venous anastomosis Following a distal finger amputation at the level of the eponychial fold we propose starting the search for veins between the 3 to 5 o'clock or 7 to 9 o'clock positions, as these are the areas where there are most likely to be suitable veins.
, Barbary S. Mini replants: fingertip replant distal to the IP or DIP joint. J Plast Reconstr Aesthet Surg . 2007. 60 (7):811-5. . Neinstein RM, Dvali LT, Le S, Anastakis DJ. Complete digital amputations undergoing replantation surgery: a 10-year retrospective study. Hand (N Y) . 2012 Sep. 7 (3):263-6. . Gavrilova N, Harijan A, Schiro S, Hultman CS, Lee C. Patterns of finger amputation and replantation in the setting of a rapidly growing immigrant population. Ann Plast Surg . 2010 May. 64(5):534-6 (...) bed. J Plast Reconstr Aesthet Surg . 2010 Nov. 63 (11):1870-4. . Tribble DE. A special skin grafting technique for concave surfaces and for traumatic amputations of fingers. Am Surg . 2010 Feb. 76(2):172-5. . Chen SY, Wang CH, Fu JP, Chang SC, Chen SG. Composite grafting for traumatic fingertipamputation in adults: technique reinforcement and experience in 31 digits. J Trauma . 2011 Jan. 70 (1):148-53. . Raitliff AHC. Amputations of the fingers and thumb. Hand . 1969. 1:137. Thompson RV