gms | German Medical Science

Objectives/Interrogation: Fingertip amputation injuries are one of the most common traumatic hand injuries. These injuries can be treated with surgical intervention such as locoregional flaps, replantation, or with terminalization. However, conservatively treated fingertip amputation injuries have an excellent regenerative ability and can lead to a functional, sensate and cosmetically pleasing fingertip. Our aim is to demonstrate our institution's experience with the conservative management of fingertip injuries with the use of semi-occlusive dressing and splint caps.

Methods: This retrospective study of consecutive patients who have sustained fingertip amputation injuries to the distal phalanx of the finger at our institution from January 2017 - July 2018. All patients attended our day surgery facility. All patients had local anaesthesia, wound debridement to the fingertip injury, followed by dressing with a semi-occlusive dressing, and thereafter the splint cap. We developed a three dimensional thermoplastic splint of the patient's original fingertip contour, termed the splint cap.

Results and Conclusions: There were 20 fingertip injuries in 20 patients who were all male. There were 25% Allen 1, 50% Allen 2 and 25% of patients with Allen 3 injuries. The mean age was 26. The mean follow-up duration was 4 months. The primary semi-occlusive dressing with splint cap was left for an average duration of 2 weeks.

In all our patients, the pulp regains satisfactory tissue cover after 4 weeks. Sensation returns within 6 weeks. 75% of patients had nail involvement. All patients had some degree of deformity of the nail. There were no serious complications such as tissue infections, neuroma, or osteomyelitis. None of the patients required a secondary flap coverage.

In conclusion, conservative treatment with semi-occlusive dressing and splint caps is a viable and cost effective alternative to the management of fingertip amputation injuries with excellent outcomes.