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Fingertip Amputation

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41. First Insights into Human Fingertip Regeneration by Echo-Doppler Imaging and Wound Microenvironment Assessment (Full text)

First Insights into Human Fingertip Regeneration by Echo-Doppler Imaging and Wound Microenvironment Assessment Fingertip response to trauma represents a fascinating example of tissue regeneration. Regeneration derives from proliferative mesenchymal cells (blastema) that subsequently differentiate into soft and skeletal tissues. Clinically, conservative treatment of the amputated fingertip under occlusive dressing can shift the response to tissue loss from a wound repair process towards (...) regeneration. When analyzing by Immunoassay the wound exudate from occlusive dressings, the concentrations of brain-derived neurotrophic factor (BDNF) and leukemia inhibitory factor (LIF) were higher in fingertip exudates than in burn wounds (used as controls for wound repair versus regeneration). Vascular endothelial growth factor A (VEGF-A) and platelet-derived growth factor (PDGF) were highly expressed in both samples in comparable levels. In our study, pro-inflammatory cytokines were relatively higher

2017 International journal of molecular sciences PubMed abstract

42. Kutler repair for the amputated fingertip. (Full text)

Kutler repair for the amputated fingertip. Fingertip amputation 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 fingertip amputation 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.

1979 Annals of the Royal College of Surgeons of England PubMed abstract

43. Kutler repair for amputated fingertip (Full text)

Kutler repair for amputated fingertip 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 amputated fingertip. 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

1979 Annals of the Royal College of Surgeons of England PubMed abstract

44. Digital Tip Amputations from the Perspective of the Nail (Full text)

Digital Tip Amputations from the Perspective of the Nail The management strategy proposed herein for fingertip amputations 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

2016 Advances in orthopedics PubMed abstract

45. The outcomes of digital tip amputation replacement as a composite graft in a paediatric population. (Abstract)

The outcomes of digital tip amputation replacement as a composite graft in a paediatric population. Limited studies exist on the outcome of replacing an amputated fingertip 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 amputated fingertip was performed. Long-term morbidity was evaluated through a standardized parental

2015 Journal of Hand Surgery - European

46. Combined Subdermal Pocket Procedure and Abdominal Flap for Distal Finger Amputations in a Toddler (Full text)

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 amputated fingertips 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

2015 Plastic and Reconstructive Surgery Global Open PubMed abstract

47. Fingertip replantation (zone I) without venous anastomosis: clinical experience and outcome analysis (Full text)

Fingertip replantation (zone I) without venous anastomosis: clinical experience and outcome analysis The purpose of this study was to report our experience of fingertip replantation without venous anastomosis using alternate method to counter post-operative venous congestion.30 Patients (18 men and 12 women) with 30 fingertip amputations (Tamai zone I) were treated with artery-only anastomosis fingertip replantation between March 2010 and July 2014. Postoperative venous outflow was maintained (...) by allowing bleeding through wound gaps combined with topical (12500u:250mlNS) and systemic (4000 IU SC once daily) heparin. The outcomes of replantation were evaluated using standard evaluating systems.The average duration of hospital stay was 10 days (range 7-14 days). Twenty-eight (93 %) replanted fingertips survived. Five replanted fingertip experienced postoperative vascular crisis. The estimated post-operative blood loss was about 200-450 ml (mean, 292 ml). Follow-up period ranged from 12 to 24

2016 SpringerPlus PubMed abstract

48. Reconstruction of Fingertip Injuries: Surgical Tips and Avoiding Complications. (Abstract)

Reconstruction of Fingertip Injuries: Surgical Tips and Avoiding Complications. The fingertip is the most commonly injured part of the hand. When replantation of a fingertip amputation is not possible, flap reconstruction may be necessary for a functional and aesthetically pleasing outcome. This paper reviews commonly utilized reconstruction techniques with a focus on technical tricks and potential complications and how to avoid them, with illustrative cases. Copyright © 2015 American Society

2015 Journal of Hand Surgery - American

49. Innervated Digital Artery Perforator Propeller Flap for Reconstruction of Lateral Oblique Fingertip Defects. (Abstract)

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

2015 Journal of Hand Surgery - American

50. Hand, Amputations and Replantation

for replantation and should be closed primarily or by recruiting adjacent soft tissues. The viability of the remaining soft tissues must be ascertained before application of a tourniquet. Occasionally, the fillet-flap principle can be applied in reconstructing these wounds. Occasionally, bone shortening or revision amputation is required to allow tension-free primary closure of the soft tissues and adequate padding. Furthermore, in an effort to minimize recovery time and hasten return to work, some fingertip (...) Hand, Amputations and Replantation Hand Amputations and Replantation: Overview, Indications, Preoperative Considerations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI4ODIwMy1vdmVydmlldw== processing > Hand

2014 eMedicine Surgery

51. Digital Amputations (Diagnosis)

phalanx. For more information about the relevant anatomy, see . Previous References Louis DS, Hunter LY, Keating TM. Painful neuromas in long below-elbow amputees. Arch Surg . 1980 Jun. 115(6):742-4. . Conolly WB, Goulston E. Problems of digital amputations: a clinical review of 260 patients and 301 amputations. Aust N Z J Surg . 1973 Sep. 43 (2):118-23. . Datiashvili RO, Knox KR, Kaplan GM. Solutions to challenging digital replantations. Clin Plast Surg . 34(2). 2007 Apr:167-75, vii. . Dautel G (...) , 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

2014 eMedicine Surgery

52. Digital Amputations (Overview)

phalanx. For more information about the relevant anatomy, see . Previous References Louis DS, Hunter LY, Keating TM. Painful neuromas in long below-elbow amputees. Arch Surg . 1980 Jun. 115(6):742-4. . Conolly WB, Goulston E. Problems of digital amputations: a clinical review of 260 patients and 301 amputations. Aust N Z J Surg . 1973 Sep. 43 (2):118-23. . Datiashvili RO, Knox KR, Kaplan GM. Solutions to challenging digital replantations. Clin Plast Surg . 34(2). 2007 Apr:167-75, vii. . Dautel G (...) , 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

2014 eMedicine Surgery

53. Digital Amputations (Treatment)

phalanx. For more information about the relevant anatomy, see . Previous References Louis DS, Hunter LY, Keating TM. Painful neuromas in long below-elbow amputees. Arch Surg . 1980 Jun. 115(6):742-4. . Conolly WB, Goulston E. Problems of digital amputations: a clinical review of 260 patients and 301 amputations. Aust N Z J Surg . 1973 Sep. 43 (2):118-23. . Datiashvili RO, Knox KR, Kaplan GM. Solutions to challenging digital replantations. Clin Plast Surg . 34(2). 2007 Apr:167-75, vii. . Dautel G (...) , 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

2014 eMedicine Surgery

54. Digital Amputations (Follow-up)

phalanx. For more information about the relevant anatomy, see . Previous References Louis DS, Hunter LY, Keating TM. Painful neuromas in long below-elbow amputees. Arch Surg . 1980 Jun. 115(6):742-4. . Conolly WB, Goulston E. Problems of digital amputations: a clinical review of 260 patients and 301 amputations. Aust N Z J Surg . 1973 Sep. 43 (2):118-23. . Datiashvili RO, Knox KR, Kaplan GM. Solutions to challenging digital replantations. Clin Plast Surg . 34(2). 2007 Apr:167-75, vii. . Dautel G (...) , 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

2014 eMedicine Surgery

55. A novel use of amniotic membrane for fingertip injuries. (Abstract)

for the treatment of fingertip amputation, 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

2014 Journal of wound care Controlled trial quality: uncertain

56. Occupational amputations in Illinois 2000-2007: BLS vs. data linkage of trauma registry, hospital discharge, workers compensation databases and OSHA citations. (Abstract)

injuries in Illinois between 2000 and 2007, compare them to the BLS-SOII, and determine OSHA investigations of the companies where amputations occurred.There were 3984 amputations identified, 80% fingertips, in the Illinois databases compared to an estimated 3637, 94% fingertips, from BLS-SOII. Though the overall agreement is close, there were wide fluctuations (over- and under-estimations) in individual years between counts in the linked dataset and federal survey estimates. No OSHA inspections (...) Occupational amputations in Illinois 2000-2007: BLS vs. data linkage of trauma registry, hospital discharge, workers compensation databases and OSHA citations. Workplace amputation is a widespread, disabling, costly, and preventable public health problem. Thousands of occupational amputations occur each year, clustering in particular economic sectors, workplaces, and demographic groups such as young workers, Hispanics, and immigrants.To identify and describe work related amputations amongst

2013 Injury

57. Fingertip Injuries (Treatment)

== 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. Fingertip amputations 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

2014 eMedicine Emergency Medicine

58. Fingertip Injuries (Diagnosis)

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 fingertip amputations. 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 fingertip amputation: a randomized

2014 eMedicine Emergency Medicine

59. Fingertip Injuries (Overview)

. 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 fingertip amputations. 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 fingertip amputation: a randomized prospective trial. Am J Emerg Med

2014 eMedicine Emergency Medicine

60. Fingertip Injuries (Follow-up)

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 fingertip amputation 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

2014 eMedicine Emergency Medicine

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