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Composite grafting for pediatric fingertip injuries

  • Published:
HAND

Abstract

Background

Fingertip injuries are common in the pediatric population. Composite grafting is a frequently used technique for distal amputations in children given the reported success rate. We sought to study the early clinical results of composite grafting for fingertip injuries in the pediatric population.

Methods

A retrospective review was performed over a 5-year period at a tertiary care pediatric hospital to identify those patients who underwent composite grafting of fingertip injuries. Patients were included if they were 18 years old or younger and sustained an injury distal to the distal interphalangeal joint (or thumb interphalangeal joint). Demographic information was recorded. Graft viability was characterized as no take, partial take, or complete take. The number of secondary procedures and number and duration of follow-up appointments were recorded. Hypothesis testing was done using ordinal logistic regression analysis.

Results

Thirty-nine patients underwent fingertip composite grafting. The mean age was 5.9 years (1–18 years); there were 24 males (61.5 %) and 15 females (38.5 %). Thirteen patients had no graft take (33.3 %), 23 patients had partial take (59.0 %), and three patients had complete take (7.7 %). Only four patients underwent secondary revision (10 %). The median number of follow-up appointments was 3 and the average follow-up time was 4.5 months. Age did not appear to have a statistically significant influence on graft take.

Conclusions

Fingertip composite grafts rarely take completely even in young children. Despite poor viability, however, most patients will have at least partial graft take and do not undergo additional reconstructive procedures.

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Conflict of Interest

Kyle R. Eberlin declares that he has no conflict of interest.

Kathleen Busa declares that she has no conflict of interest.

Donald S. Bae declares that he has no conflict of interest.

Peter M. Waters declares that he has no conflict of interest.

Brian I. Labow declares that he has no conflict of interest.

Amir H. Taghinia declares that he has no conflict of interest.

Statement of Human and Animal Rights

The authors certify that all institutional and national guidelines for the care and use of laboratory animals were followed in this study.

Statement of Informed Consent

Informed consent was obtained for the procedures performed in this study, although patient identifying information has been omitted from the manuscript.

Disclosures

None of the authors has any financial interest in any of the products, devices, or drugs mentioned in this manuscript, or any other conflict of interest to disclose.

Level of Evidence

Clinical Question: Therapeutic

Level of Evidence: IV

Author information

Authors and Affiliations

  1. Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Kyle R. Eberlin

  2. Department of Plastic and Oral Surgery, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA

    Kathleen Busa, Brian I. Labow & Amir H. Taghinia

  3. Department of Orthopedic Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Donald S. Bae & Peter M. Waters

Authors
  1. Kyle R. Eberlin
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  2. Kathleen Busa
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  6. Amir H. Taghinia
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Corresponding author

Correspondence to Amir H. Taghinia.

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Eberlin, K.R., Busa, K., Bae, D.S. et al. Composite grafting for pediatric fingertip injuries. HAND 10, 28–33 (2015). https://doi.org/10.1007/s11552-014-9671-5

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  • DOI: https://doi.org/10.1007/s11552-014-9671-5

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