Skip to main content

Fingertip Injuries

  • Chapter
  • First Online:
Pediatric and Adult Hand Fractures

Abstract

The distal aspect of the fingertip is a complex tool that allows us to work with and react to our surroundings daily. In our era of touch-screen technology and fingerprint security, the fingertip plays an especially crucial role in allowing us to seamlessly interact with our modern environment. It is not surprising that this critical area is also the most commonly injured aspect of the hand given its location and usage, and fingertip injuries can severely hinder many activities of daily living. The fingertip can be injured by a number of forces but lacerations are most frequent, followed by deforming crush injuries. Avulsions are the least likely injury. Crush injuries in particular are associated with concurrent distal phalanx fractures. Because the fingertip relies on a number of sensory structures, the goal of reconstruction when dealing with these injuries is to restore function and maintain sensation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kakar S. Chapter 49: Digital amputations. In: Wolfe S, Hotchkiss N, Pederson WC, Kozin SH, Cohen MS, editors. Green’s operative hand surgery. 7th ed. Philadelphia, PA: Elsevier; 2017. p. 1708–52.

    Google Scholar 

  2. Dautel G. Chapter 13: Nail trauma. In: Merle M, Dautel G, editors. Emergency surgery of the hand. 1st ed. Amsterdam: Elsevier; 2016. p. 332–43.

    Google Scholar 

  3. Dautel G. Chapter 9: Finger and hand soft tissue defects. In: Merle M, Dautel G, editors. Emergency surgery of the hand. 1st ed. Amsterdam: Elsevier; 2016. p. 156–267.

    Google Scholar 

  4. Flint MH. Some observations on the vascular supply of the nail bed and terminal segments of the finger. Br J Plast Surg. 1955;8:186–95.

    Article  CAS  PubMed  Google Scholar 

  5. Mailey B, Neumeister MW. Chapter 6: The fingertip, nail plate and nail bed: anatomy, repair, and reconstruction. In: Chang J, Neligan PC, editors. Plastic surgery E-book: volume 6: hand and upper extremity. 4th ed. Philadelphia, PA: Elsevier Health Sciences; 2018. p. 122–46.

    Google Scholar 

  6. Schick C. Chapter 10: Nail bed and fingertip injuries. In: Principles of hand surgery and therapy. 3rd ed. Philadelphia, PA: Elsevier; 2017. p. 193–205.

    Google Scholar 

  7. Allen MJ. Conservative management of finger tip injuries in adults. Hand. 1980;12(3):257–65.

    Article  CAS  PubMed  Google Scholar 

  8. Evans DM, Bernadis C. A new classification for fingertip injuries. J Hand Surg. 2000;25(1):58–60.

    Article  CAS  Google Scholar 

  9. Zook EG, Guy RJ, Russell RC. A study of nail bed injuries: causes, treatment, and prognosis. J Hand Surg [Am]. 1984;9:247–52.

    Article  CAS  Google Scholar 

  10. Dean B, Becker G, Little C. The management of the acute traumatic subungual haematoma: a systematic review. Hand Surg. 2012;17:151–4.

    Article  PubMed  Google Scholar 

  11. Seaberg DC, Angelos WJ, Paris PM. Treatment of subungual hematomas with nail trephination: a prospective study. Am J Emerg Med. 1991;9(3):209–10.

    Article  CAS  PubMed  Google Scholar 

  12. Roser SE, Gellman H. Comparison of nail bed repair versus nail trephination for subungual hematomas in children. J Hand Surg [Am]. 1999;24:1166–70.

    Article  CAS  Google Scholar 

  13. Ogunro O, Ogunro S. Avulsion injuries of the nail bed do not need nail bed graft. Tech Hand Up Extrem Surg. 2007;11(2):135–8.

    Article  PubMed  Google Scholar 

  14. O’Shaughnessy M, McCann J, O’Connor TP, Condon KC. Nail re-growth in fingertip injuries. Ir Med J. 1990;83(4):136–7.

    PubMed  Google Scholar 

  15. Hoigné D, Hug U, Schürch M, Meoli M, Von Wartburg U. Semi-occlusive dressing for the treatment of fingertip amputations with exposed bone: quantity and quality of soft-tissue regeneration. J Hand Surg. 2014;39(5):505–9.

    Article  Google Scholar 

  16. Mennen U, Wiese A. Fingertip injuries management with semiocclusive dressing. J Hand Surg. 1993;18(4):416–22.

    Article  CAS  Google Scholar 

  17. Sturman MJ, Duran RJ. The late results of fingertip injuries. J Bone Joint Surg Am. 1963;45:289–98.

    Article  Google Scholar 

  18. Holm A, Zachariae L. Fingertip lesions: an evaluation of conservative treatment versus free skin grafting. Acta Orthop Scand. 1974;45:382.

    Article  CAS  PubMed  Google Scholar 

  19. Eberlin KR, Busa K, Bae DS, et al. Composite grafting for pediatric fingertip injuries. Hand. 2015;10:28–33.

    Article  PubMed  Google Scholar 

  20. Moiemen NS, Elliot D. Composite graft replacement of digital tips. A study in children. J Hand Surg. 1997;22:346–52.

    Article  CAS  Google Scholar 

  21. Yang G, Kamnerdnakta S, Brown M, Chung KC. Procedure 72: Flap coverage of fingertip injuries. In: Operative techniques: hand and wrist surgery. 3rd ed. Philadelphia, PA: Elsevier; 2017. p. 655–64.

    Google Scholar 

  22. O’Brien B. Neurovascular island pedicle flaps for terminal amputations and digital scars. Br J Plast Surg. 1968;21:258–61.

    Article  PubMed  Google Scholar 

  23. Wang K, Sears ED, Shauver MJ, Chung KC. A systematic review of outcomes of revision amputation treatment for fingertip amputations. Hand. 2013;8(2):139–45.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Taras JS, Sapienza A, Roach JB, Taras JP. Acellular dermal regeneration template for soft tissue reconstruction of the digits. J Hand Surg [Am]. 2010;35(3):415–21.

    Article  Google Scholar 

  25. Weigert R, Choughri H, Casoli V. Management of severe hand wounds with Integra® dermal regeneration template. J Hand Surg. 2011;36:185.

    Article  CAS  Google Scholar 

  26. Chen F, Schneider LH. Fractures of the distal phalanx. Oper Tech Orthop. 1997;7(2):107–15.

    Article  CAS  Google Scholar 

  27. Merle M, Jager T. Chapter 7: Metacarpal and phalangeal fractures. In: Merle M, Dautel G, editors. Emergency surgery of the hand. 1st ed. Philadelphia, PA: Elsevier; 2016. p. 100–47.

    Google Scholar 

  28. Schuler MS, Roskosky M, Kinney J, Elstad Z. Chapter 2: Phalangeal fractures and interphalangeal joint injuries. In: Principles of hand surgery and therapy. 3rd ed. Philadelphia, PA: Elsevier; 2017. p. 27–55.

    Google Scholar 

  29. Wehbé MA, Schneider LH. Mallet fractures. J Bone Jt Surg Am. 1984;66(5):658–69.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Adam Strohl .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Deivasigamani, S., Gundlach, B., Strohl, A. (2023). Fingertip Injuries. In: Abzug, J.M., Gaston, R.G., Osterman, A.L., Tosti, R.J. (eds) Pediatric and Adult Hand Fractures. Springer, Cham. https://doi.org/10.1007/978-3-031-32072-9_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-32072-9_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32071-2

  • Online ISBN: 978-3-031-32072-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics