gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Artikel

Artikel empfehlen

Tip finger traumatic injury. Treatment with semi-permeable membrane

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Marcelo Schieber - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina
  • Adriana Beatriz Pemoff - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina
  • Maria Emilia Capella - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina
  • Pedro Nicolas Tajan - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina
  • Analia Claudia Boianelli - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina
  • Anabel Oviedo - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina
  • Aldo Payalaf - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina
  • Federico Castillo - Centro Médico Integral Fitz Roy, Buenos Aires, Argentina

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1146

doi: 10.3205/19ifssh0764, urn:nbn:de:0183-19ifssh07647

Veröffentlicht: 6. Februar 2020

© 2020 Schieber et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: Tip finger injury is a prevalent pathology in manual workers. Different surgery techniques have been described for their treatment, with the aim to restore length, functionality and to recover sensitivity in tip finger pulps.

Our work shows that, by using the conservation treatment with semi-permeable dressing, good results are obtained without causing injury to adjacent parts of the hand, as in the case of flaps and grafts. Moreover, finger length could also be preserved.

Methods: A retrospective study was carried out in 33 patients, 43 fingers, with one-year follow-up, using Professor Dr. Rodolfo Cosentino's classification (TYPE A Amputation with right angle A1- Distal without bone exposure. A2- through bed nail. A3- next to bed nail matrix. A4- next to interphalageal joint. TYPE B- dorsal angulation amputation. TYPE C- palmar angulation amputation. TYPE D- lateral angulation amputation.)

Injuries type A to D were included. All of the injuries were treated with semi-permeable dressing every seven days, till epithelialization was achieved.

In order to evaluate results, skin coverage time and return time to work were registered. Besides, monofilament test (Semmens- Weinstein) was used so as to measure sensitivity recovery.

Out of the 43 fingers studied and according to Cosentino classification, we registered: A1 (out of 4 cases: 2 full touch recovery, 2 slight touch reduction), A2 (out of 5 cases: 1 full touch recovery, 4 slight touch reduction), A3 (out of 12 cases: 5 full touch recovery, 6 protective touch reduction, 1 anesthesia), B (out of 6 cases: 2 full touch recovery, 4 slight touch reduction), C (out of 10 cases: 2 cases of slight touch reduction, 6 protective touch reduction, 1 protective touch loss, 1 anesthesia) and D (out of 6 patients: 1 full touch recovery, 1 slight touch reduction, 4 full touch recovery)

Results and Conclusions: In 100% of the cases skin coverage was achieved, independently of the traumatic injury mechanism.

Differences were seen as regards reepithelization time according to injury type, presence of sequels at nail level (bed nail, matrix and onychogyphosis flaws), touch recovery and return to work.

As a conclusion, we can state that the method is simple, easily reproductable, extrapolable in a wide range of ages and injuries, with good functional and cosmetics results without compromising surrounding areas as it occurs in cases of free skin grafts or local flaps.