gms | German Medical Science

Objectives/Interrogation: Fingertip injuries are common and there are numerous options available for management. The aim is to explore the preferences between how surgeons would want their own fingertip injuries treated compared to how surgeons would treat patients with similar fingertip injuries.

Methods: This qualitative study used a purposeful sampling with an online survey form, distributed to surgeons worldwide via a social media platform. These surgeons were from a community of surgeons on LinkedIn and Facebook. 3 different cases were presented to respondents - case 1 was an Allen 1 injury, case 2 was an Allen 3 injury with 2mm exposed bone, and case 3 was a crush injury of the distal phalanx. Respondents were invited to opine on their management preferences in these scenarios if these were their patients and their own fingertip injuries.

Results and Conclusions: There were 30 respondents. 60% males, 50% practicing in Europe, 36.7% in the Asia-Pacific region. 53.3% had >10 years of experience in surgery, 26.7% had 5-10 years. 36.7% were senior consultants, 43.4% were (associate) consultants.

For case 1, 73.3% would treat both patients and themselves identically, conservatively with toileting and dressing. The remaining would treat both patients and themselves identically, surgically - 6 chose local flaps, 1 a distal flap. 1 respondent chose local flap for his patient, but elected for microsurgical reconstruction with pulp transplant for his own care.

For case 2, 30% would treat both patients and themselves identically, conservatively with toileting and dressing. 4 also chose to shorten the bone. The remaining chose surgical treatment for their patients, of which 66.7% chose surgical treatment on themselves. This respondent elected to treat his own fingertip injury conservatively with simple dressing while treating his patient's with a local flap. Otherwise, the remaining would perform identical surgical treatment on both patients and themselves. 13 respondents chose local flaps, 2 replantation, 2 microsurgical reconstruction with pulp transplant, 1 each for distal flap, terminalization, and grafting.

For case 3, all chose identical treatments for both patients and themselves - 83.3% chose conservative treatment with toileting and suturing the wound followed by dressing. The remaining elected to remove nail with nail bed repair followed by a fingertip splint.

In conclusion, most surgeons would want their own fingertip injuries treated identically to how they would treat patients with similar fingertip injuries.