Management of Pediatric Distal Fingertip Injuries (original) (raw)
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Fingertip Injuries in Children: Epidemiology, Financial Burden, and Implications for Prevention
Hand (New York, N.Y.), 2017
Although fingertip injuries are common, there is limited literature on the epidemiology and hospital charges for fingertip injuries in children. This descriptive study reports the clinical features of and hospital charges for fingertip injuries in a large pediatric population treated at a tertiary medical center. Our hospital database was queried using International Classification of Diseases, Revision 9 (ICD-9) codes, and medical records were reviewed. Frequency statistics were generated for 1807 patients with fingertip injuries who presented to the emergency department (ED) at Boston Children's Hospital (BCH) between 2005 and 2011. Billing records were analyzed for financial data. A total of 1807 patients were identified for this study; 59% were male, and the mean age at time of injury was 8 years. Most commonly, injuries occurred when a finger was crushed (n = 831, 46%) in a door or window. Average length of stay in the ED was 3 hours 45 minutes, 25% of cases needed surgery, ...
Fingertip injury: A case report in emergency departments
International journal of health & medical sciences, 2023
Fingertip injury is one of the most common injuries to the hand. Injuries can include damage to the skin and soft tissue, bones (distal phalanx), nails and nailbeds. The fingertips are rich in nerves and very sensitive. Without prompt and precise treatment, finger injuries can interfere with the complex function of the hand and may result in permanent deformity and disability. This report aims to report management in patients with fingertip injuries. A 25-year-male patient with a fingertip injury in the area of the right index finger. The results of the local status examination found a laceration measuring 3x1,5 cm with uneven edges in the aspectus volar in the distal phalanx in the II digit along with tenderness and no limited finger movement. Patients treated with pharmacotherapy and operative measures for the reconstruction of fingertip injuries, with a local flap using the V-Y flap method.
Fingertip Injuries and Amputations: A Review of the Literature
Cureus, 2020
The fingertip is defined as the part of the digit distal to the insertion of the extensor and flexor tendons on the distal phalanx. Devastating injuries to the hand occur every year that lead fingertip amputations in thousands of people. The highest incidence rates are usually seen in children less than five years old and in adults over the age of 65. There are various presentations of injury that may end up with post-traumatic fingertip amputation, including lacerations, avulsions, and crush injuries. The fingertip is vital for sensation, as it has a high concentration of sensory receptors, and hence the restoration of sensation is the most important focus of treatment. The three main goals of treatment are the restoration of sensation and durability in the tip and assuring proper bone support to allow for nail growth. Many complications can arise after fingertip amputation, including delayed wound healing, nail deformities with poor aesthetics, hypersensitivity, residual pain, cold intolerance, scar retraction, flexion contractures, chronic ulceration, infection, and flap loss. The objective of this study is to provide an overview of the anatomy of the fingertip, the presentation of fingertip injuries and their management, and complications that might arise after surgery.
Indian J Orthop, 2007
Background: Fingertip injuries are extremely common. Out of the various available reconstructive options, one needs to select an option which achieves a painless fingertip with durable and sensate skin cover. The present analysis was conducted to evaluate history including patient's demographics, mechanism of 1cm without exposed bone or tendon, split-thickness injury, hand dominance, occupation, duration since injury grafting (n=20) was performed. Full-thickness grafting the management and outcome of fi ngertip injuries. Materials and Methods: This is a retrospective study of 150 cases of fingertip Injuries of patients aged six to 65 years managed over a period of two years. Various reconstructive options were considered for the fingertip lesions greater than or equal to 1 cm 2 The total duration of treatment varied from two to six weeks with follow-up from two months to one year. Results: The results showed preservation of finger length and contour, retention of sensation and healing without significant complication. Conclusion: The treatment needs to be individualized and all possible techniques of reconstruction must be known to achieve optimal recovery.
Acute Fingertip Injuries in Sudanese Patients: Patterns and Clinical Presentation
Modern Plastic Surgery
Background: Acute fingertip injuries are common and may lead to functional and aesthetic complications if not treated properly. Different types of trauma result in injuries with variable severity and affect certain risk groups. Objectives: To study the high-risk groups affected by fingertip injuries, their etiological factors, clinical features, and wound patterns, and the influence of hand dominance. Study Design: A descriptive study of 103 consecutive patients with 144 acutely injured fingertips. Data Collection/Analysis: We obtained demographic data, occupation, hand dominance, time and cause of trauma, and the presenting symptoms. Further, clinical examination, radiological, and laboratory studies were performed. Wound characteristics were classified according to the pulp, nailbed and bone (PNB) classification. The data were analyzed with the Fisher's exact test and Chi-square test. Results: A total of 103 patients (88 males, 15 females) presented with 144 injured fingertips. The male to female ratio was 5.8:1, and the mean age was 27.5 years. The age group affected most commonly was 16-20 years. There was a strong association between hand dominance and fingertip injuries, as in 65% of the cases, the dominant hand was injured more frequently than the non-dominant (p = 0.01). The sharp and blunt injuries observed involved the left hand more than the right and were often the result of machinery-related trauma (p = 0.04). Approximately 68% of the injuries were related to work, while 26% were attributable to domestic accidents. In 22% of the cases, seasonal workers were the category affected most often, followed by factory workers. Nearly half of the injuries were related to working with machines, while door-trapping was the most frequent cause of injury in children under 5. The index finger was injured most frequently (31.9%), followed by the middle finger (27.9%), while the thumb and little fingers were involved least (11% for each).
Finger ? tip injuries are one of the most common injuries faced in the Emergency department of any hospital. This article deals with the experience of our hospital, over a period of 2 Years ? From September 2014 to September 2016 done as a prospective study. Ninety Patients that underwent some form of surgical Procedure were included and followed up over a period of six month. The analysis focused on factors such as mode of injury ? viz. Domestic, Industrial, Road traffic accidents etc, Hand Dominance, Digit involved, Surface involved, Procedure employed, Time taken to return to work, functional outcome and aesthetics. Out of Ninety, Thirty eight patients could be followed up fully. Choice of surgical procedure was made based on the orientation and configuration of the wound. Most of the patients were right handed. Index finger was the commonest digit involved followed by middle, ring, little fingers and thumb. Return to work time was delayed in patients with heterodigital flaps. Most of the patients were satisfied with the aesthetic outcome.
Functional and Aesthetic Outcome of Fingertip Injuries' Management
The Egyptian Journal of Plastic and Reconstructive Surgery, 2020
Background: Fingertip injuries are the most common injuries that occur to the hand, accounting for 4.8 million Emergency Department visits per year. Fingertip injuries requires immediate intervention to avoid any complications or deformities. Several therapeutic modalities have been used for treatment; either surgical or conservative treatment and each of them has its own advantages and disadvantages. However, evidence is still lacking in the literature supporting either surgical or conservative lines of treatment. The purpose of the present study is to compare functional and aesthetic outcomes between surgical and conservative treatment of fingertip injuries. Methods: This prospective study included 50 patients with Allen's type II and III of fingertip injuries divided into two groups; Group I included 20 patients treated surgically and Group II included 30 patients treated conservatively which is further subdivided into subgroup I (Platelet Gel), subgroup II (Hyaluronic acid) and subgroup III (Fucidic acid). Results: The conservative treatment showed a significant improvement regarding the sensory outcome, the range of motion, rate of complications, the aesthetic outcome and the patients' satisfaction (p=0.002, 0.001, 0.021, 0.035, 0.026 respectively). The platelet gel in the conservative treatment showed a significantly shorter time of healing compared to other modalities of conservative treatment (p=0.004) thus a significant faster recovery and shorter time off-work (p=0.001). Conclusion: We concluded that the conservative treatment provides better functional and aesthetic outcome in treating fingertip injuries. The use of platelet gel in fingertip injuries is associated with decreased time of healing and early return to work.
Hand injuries in children and adolescents
Srpski arhiv za celokupno lekarstvo, 2021
Introduction/Objective. The objective of the study was to determinate which groups in the population of children are most prone to hand injuries and to identify the causes of the injuries with the aim of further developing better means of severe injuries prevention that can lead to invalidity. Methods. A retrospective epidemiological study was carried out, and included all children with hand injuries admitted to our hospital between January 1, 2010 and December 31, 2017; The data were collected and analyzed statistically using SPSSR. Significance was defined as p < 0.05. Results. The total number of patients was 254, 202 boys and 52 girls, with a mean age for both sexes 10.13 years (range1?17). The majority of patients were from an urban population 56.7% and 43.3% were from a rural area. Regarding the month in the year when the injury occurred, there were two peaks, in January and in May. The right hand was more affected, 53.2%, than the left, 45.6%, and both hands were affected ...
Pediatric Fingertip Injuries: Association With Child Abuse
Journal of Hand Surgery Global Online
Pediatric fingertip injuries are most commonly reported in the setting of an accidental occurrence. The purpose of this study was to determine whether there is an association of child abuse and neglect with pediatric fingertip injuries. Methods: The New York Statewide Planning and Research Cooperative System (2004 to 2013) administrative database was used to identify children aged 0 to 12 years who presented in the inpatient or outpatient (emergency department or ambulatory surgery) setting. International Classification of Diseases, Ninth Revision diagnosis codes were used to identify fingertip injuries (amputation, avulsion, or crushed finger) and abuse. Cohort demographics of children presenting with fingertip injuries were described. We analyzed the association between fingertip injuries and child abuse using multivariable logistic regression, with variables for insurance status, race, ethnicity, sex, and behavioral risks including depression, attention-deficit hyperactivity disorder, aggressive behavior, and autism. Results: Of the 4,870,299 children aged 0 to 12 years in the cohort, 79,108 patients (1.62%) during the study period (2004 to 2013) presented with fingertip injuries. Of those with a fingertip injury, 0.27% (n ¼ 216) presented either at that visit or in other visits with a code for child abuse, compared with 0.22% of pediatric patients without a fingertip injury (n ¼ 10,483). In an adjusted analysis, the odds of a fingertip injury were 23% higher (odds ratio [OR] ¼ 1.23; 95% confidence interval [CI], 1.07e1.41) for children who had been abused, compared with those who had not. Patients were more likely to present with fingertip injuries if they had ever had Medicaid insurance (OR ¼ 1.40; 95% CI, 1.37e1.42) or had a behavioral risk factor (OR ¼ 1.35; 95% CI, 1.30e1.40). Conclusions: Patients presenting with abuse are significantly more likely to have fingertip injuries during childhood compared with those without recorded abuse, which suggests that these injuries may be ones of abuse or neglect. Medicaid insurance, white race, and behavioral diagnoses of depression, attentiondeficit hyperactivity disorder, aggressive behavior, and autism were also associated with increased odds of presenting with fingertip injuries. Type of study/level of evidence: Prognostic III.