Background: Hand trauma especially fingertip injury is one of the commonest presentations in emergency departments. Fingertip reconstruction is a delicate procedure and there are different approaches for fingertip repair ranging from the simplest procedure to the most sophisticated one to achieve the best functional outcome. The study aims to establish an algorithm for the best reconstructive options for each type of fingertip injuries according to the experience of El Helmya Armed Forces Hospital.

Patients and Methods: This is a retrospective cohort study for different approaches for each type of fingertip injuries and was conducted on all admitted patients with fingertip injuries from January 2018 to January 2021 in El Helmya Armed Forces Hospital, Egypt.

Results: From 282 patients who met our inclusion criteria, the index finger was the most commonly injured in 83 patients (29.4%) while the thumb finger was the least injured one in only 19 patients (6.7%). 107 patients (37.9%) were classified according to Allen's classification as type I injury followed by type III injury in 65 patients (23%). Healing by secondary intention was the most prevalent option for the management of type I injuries in 31 patients (29%) while shortening and direct closure procedure was the commonest strategy for the management of type IV injuries in 36 patients (70.6%).

Conclusion: Algorithms for the management of fingertip injuries may be different for military people because patients' occupations and early return to the field with minimal disability are cornerstones for treating such injuries.