Secondary intention healing for fingertip amputation with exposed bone.

PURPOSE

This study aimed to evaluate the outcomes of treating exposed bone fingertip amputations using the secondary intention healing method, and to analyze the correlation between the severity of the injury, as defined by the Allen classification, and the results of the treatment.

METHODS

A prospective descriptive study was conducted on 40 patients with fingertip amputation of Allen types 2-4 and exposed bone (≤2 mm) from May 2023 to January 2024. Patients were treated using the secondary intention healing method with a multi-layer moist dressing protocol, which included castor oil, non-adhesive Urgotul gauze, saline-moistened gauze and rubber glove fingertip coverage. The Fingertip Injuries Outcome Score (FIOS) was used to evaluate outcomes after 6 months of follow-up.

RESULTS

The mean age was 32.5 ± 9.27 years, and 82.5% of participants were male. The distribution by Allen classification was as follows: type 2 (50%), type 3 (35%), and type 4 (15%). The mean FIOS score was 15.08 ± 3.10. Excellent results were achieved by 12.5% of patients, good results by 62.5%, and fair results by 25%. FIOS scores increased with injury severity: For Allen types 2, 3 and 4, the scores were 12.80 ± 1.11, 16.14 ± 2.31 and 20.17 ± 1.17, respectively. A strong positive correlation was found between the Allen classification and the FIOS scores (r = 0.80, p < 0.001). The average healing time was 3.95 ± 0.75 weeks. The infection rate was 5%, with 2.5% of cases requiring surgical intervention.

CONCLUSIONS

The secondary intention healing method is an effective treatment for exposed bone fingertip amputations, particularly Allen types 2 and 3. Injury severity according to the Allen classification correlates directly with FIOS scores, indicating poorer outcomes for more severe injuries, though these remain within acceptable limits.

LEVEL OF EVIDENCE

Level IV, Case Series.