Therapy of Fingertip Injuries

Abstract

Objective/Hypothesis: Fingertip injuries are very common in emergency departments, and reconstruction is a central aim of their management. According to the literature, fingertip injuries in the level of Allen 3 and Allen 4 should be treated by local skin flaps. Main purpose of this study was to evaluate the outcome after semiocclusive dressing therapy in respect to soft tissue cover, recovery of sensibility, and duration of sick leave. Materials and Methods: One hundred fourteen fingertip injuries from 2009 to 2011, treated with semiocclusive dressing, were retrospective analyzed. In all of the cases, the injured fingers were only cleaned, debrided, and covered with an occlusive dressing. The bone was not shorted, even if the bone was up to the wound level. The primarily occlusive dressing was left as long as possible and had been, when necessary, obdurated. The different types of fingertip injuries were classified according to the levels set by Allen. Furthermore, the treatment time with the semiocclusive dressing and the period of disability were recorded. On every patient, a Semmes-Weinstein test was performed to document the sensitive outcome. Results: A total of 114 patients were treated with a semiocclusive dressing. The mean age was 36 ± 14 years, and the mean treatment duration was 21 ± 10 days. The mean period of disability was 30 ± 17 days. After taking off the semiocclusive dressing, the main period of disability was 8 ± 13 days. According to Allen, following composition of fingertip injuries occurred: 49% Allen 1, 33% Allen 2, 13% Allen 3, and 5% Allen 4. All patients developed a satisfactory tissue cover, and the sensibility, according to the Semmes-Weinstein test, was normal. There were no complications like tissue infections, neuroma, or osteitis. Also no secondary flap supply was necessary. Conclusion: The semiocclusive dressing is an ideal therapy for all kind of fingertip injuries, regardless of the amputation level. There may be even bone exposed on the wound level. It is an easy, cheap, and safe therapy with no complications and leads to an excellent result in function, sensibility, and carry capacity. The semiocclusive dressing is a suitable alternative in treating fingertip injuries.