Background: Chronic deformity can result from inadequately repaired fingertip injuries, and correcting these abnormalities typically necessitates a more challenging secondary reconstructive treatment with less consistent results compared to a well-managed initially repaired. The present work aimed to evaluate different methods of treatment of fingertip injuries in emergency department at Zagazig university hospitals.

Methods: Twenty-seven patients (with 35 injured fingertips) with different types of fingertip injuries who were admitted to the emergency unit of the Plastic and Reconstructive Surgery Department in Zagazig University Hospitals were enrolled in this prospective case series study. After debridement of dead tissues, re-exploration of the injury was done to determine the management plan according to Allen's classification of the fingertip injury. During follow up visits, outcomes were assessed utilizing the fingertip injuries outcome score based on nail aesthetics, pulp pad, aesthetic outcome, sensation, grip strength, and return to work.

Results: Most cases returned to regular work, with high grip strength, preserved sensations and well-padded pulp. The nail was normal in 65.7% of cases, small in 22.9% of cases, split in 0% of cases, hooked in 5.7% of cases and absent in 14.3% of cases. There was a high patient and doctor satisfaction.

Conclusion: The choice of the most suitable management option depends on surgeon factors like experience as well as the skills, and patient factors like age, sex as well as occupation in addition to the defect analysis (injured finger, type of injury and bone exposure).