Ilavarasan Sushmi, R Manimaran, Kanchana Koppolu
General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.
Plastic Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.
Cureus. 2025 May 28;17(5):e84975. doi: 10.7759/cureus.84975. eCollection 2025 May.
Fingertip injuries are among the most frequently encountered hand traumas in clinical settings and often result from occupational, recreational, or domestic incidents. These injuries range from simple lacerations and avulsions to more complex presentations involving severe tissue loss, exposed bone, fractures, and nail bed disruptions. Given the intricate anatomy of the fingertip, comprising soft tissue, bone, nerves, and the nail unit, these injuries can significantly compromise hand function, sensation, dexterity, and aesthetic appearance. Prompt and appropriate management is crucial to minimize complications and restore optimal hand utility. This case series documents six patients with traumatic fingertip injuries, classified according to Allen's classification system, which helps determine the extent of soft tissue and bony involvement. Surgical management strategies were tailored based on the injury type and included V-Y advancement flaps, cross-finger flaps, nail bed repair, and bone shortening with primary closure. The selection of surgical technique was guided by the goal of preserving finger length, maintaining function, and achieving satisfactory cosmetic outcomes. Postoperative evaluation focused on key outcomes such as wound healing, sensory recovery, time to return to daily activities or work, and the effectiveness of rehabilitation. Five out of six patients showed excellent recovery, resuming functional use of their hands within 3-5 weeks. One patient, however, experienced a poorer outcome due to extensive bone shortening, underscoring the limitations of certain procedures in cases of severe structural damage. This study highlights the effectiveness of a systematic, classification-based approach to fingertip injury management. It also emphasizes the importance of individualized surgical planning, early intervention, and structured rehabilitation in promoting successful outcomes.
指尖损伤是临床环境中最常见的手部创伤之一,通常由职业、娱乐或家庭事故导致。这些损伤范围从简单的撕裂伤和撕脱伤,到涉及严重组织缺失、暴露骨骼、骨折和甲床破坏的更复杂情况。鉴于指尖复杂的解剖结构,包括软组织、骨骼、神经和指甲单元,这些损伤会显著损害手部功能、感觉、灵活性和美观。及时且恰当的处理对于将并发症降至最低并恢复手部的最佳功能至关重要。本病例系列记录了6例创伤性指尖损伤患者,根据艾伦分类系统进行分类,该系统有助于确定软组织和骨骼受累的程度。手术治疗策略根据损伤类型进行定制,包括V-Y推进皮瓣、邻指皮瓣、甲床修复以及骨缩短并一期缝合。手术技术的选择以保留手指长度、维持功能和实现满意的美容效果为目标。术后评估聚焦于伤口愈合、感觉恢复、恢复日常活动或工作的时间以及康复效果等关键结果。6例患者中有5例恢复良好,在3至5周内恢复了手部的功能使用。然而,1例患者由于广泛的骨缩短而预后较差,这凸显了在严重结构损伤病例中某些手术的局限性。本研究强调了基于分类的系统性方法在指尖损伤处理中的有效性。它还强调了个体化手术规划、早期干预和结构化康复在促进成功结果方面的重要性。