Ditmars D M
Division of Plastic and Reconstructive Surgery, Henry Ford Hospital, Detroit, MI 48202.
Occup Med. 1989 Jul-Sep;4(3):449-61.
Damage to any of the anatomic structures of the finger tip can result in a change in use of the hand, even making some tasks impossible. Prevention is naturally most important; however, when an injury occurs, anatomic restoration should be the goal. Treatment should be the most direct and simple to reach the optimal structural and functional result. Caveats of treatment are: (1) save nails; (2) reapproximate nail matrix lacerations; (3) use wound contraction and epithelialization to advantage; (4) restore pulp when necessary with volar innervated flaps from the same finger; (5) reduce fracture angulation and displacement; (6) use skin grafts when subcutaneous tissue is sufficient; and (7) replace small noncrushed skin-pulp amputations and traumatic flaps.
指尖任何解剖结构的损伤都可能导致手部使用方式的改变，甚至使一些任务无法完成。预防自然是最为重要的；然而，当损伤发生时，解剖结构的修复应成为目标。治疗应最为直接且简单，以达到最佳的结构和功能效果。治疗的注意事项包括：（1）保留指甲；（2）使甲床裂伤重新对合；（3）利用伤口收缩和上皮形成的优势；（4）必要时用同一手指掌侧带神经的皮瓣修复指腹；（5）减少骨折成角和移位；（6）当皮下组织充足时使用皮肤移植；以及（7）替换小面积未压碎的皮肤 - 指腹截肢和外伤性皮瓣。
