Background: Fingertip amputations are the most common
type of amputation injury in the upper extremity. Treatments
available cover a broad range of techniques, surgical and
conservative. Although there is no consensus on how these
injuries should be treated, the goals of treatment should include
minimization of pain, optimization of healing time, preservation
of sensibility and length, prevention of painful neuromas,
avoidance or limiting of nail deformity, minimization of time
lost from work, and provision of an acceptable cosmetic
appearance.
Patients and Methods: We have prospectively studied 20
patients with fingertip amputations of all ages. Daily simple
non adherent non occlusive dressing, paraffin-impregnated
gause, with an ointment initially for debridement then for
healing was used. We used pinch gauge, finger goniometer,
caliper and compass to measure pinch tip strength, distal
phalanx range of motion and 2 point discrimination distance,
respectively.
Results: The mean age was (33±17.3) years old. The mean
healing time was (36.4±5.8) days and mean time off work
was (11.6±7.6) days. As regards sensibility 30% complain
numbness, 35% had hyper-sensibility, and 35% show normal
sensibility. As regards two point discrimination in the corresponding
healthy fingertip, the mean distance was (4.7±1.5)
mm, versus (8.6±2.5) mm in amputated fingertip. There was
no tenderness, cold intolerance, joint stiffness, neuroma or
disability. 50% expressed good aesthetic results, 40% of
patients were accepted, and 10% had poor aesthetic results.
Conclusion: The functional outcome was good, as there
were no tenderness, cold intolerance, joint stiffness, neuroma
or disability. Although, longer healing time, time off work
was generally acceptable. Irrespective of that a 35% of patients
have hyper-sensibility and 30% complained of numbness,
there were no significant bad impact on the function and early
return to work. Aesthetically, hook nail deformity was the
only cause of poor aesthetic results. However, conservative
management of fingertip amputations using simple daily
dressing changes, provides good and acceptable results outweighs
the poor results.