Fingers like our eyes act as our window to see the world by touching and feeling. Fingertip injuries are quite common in the industrial workplace due to the nature of the work profile. Mostly we see crush injuries from heavy press machines or partial and total amputations from sharp cutting machines. The second most common fingertip injuries happen to kids while playing. Most commonly crush injuries with doors are seen with kids. At times I have received kids with fingertips damaged while trying to repair cycle chains.
For a common man, any injury beyond the distal-most crease of a finger is a fingertip injury. Technically fingertip is the area beyond the insertion of the FDP tendon. It mainly consists of pulp and nailbed. Regardless of how it happened these injuries need to be repaired with utmost care and perfection. These repairs demand magnification for a flawless repair. The goal of surgery is that the finger should be functional after repair and healing.
More so fingertips are exposed parts of the body visible to everyone. Repairs should be with the least scarring and cosmetically pleasing.
Fingertip injuries are unique in the sense that they are always different in different patients and every patient needs a tailored customized approach. When repairing we try to restore the functions and anatomical structures as much as possible.
These injuries need a limb salvage approach and patience for repairs. Sometimes reconstruction of tiny vessels and nerves may take hours.
Plastic surgeons are trained in microsurgery and as a trained microsurgeon I have a lot more options available with me for complex repairs. We can zoom up to 20-25x for the repair of these structures especially in children with tiny structures.
These injuries may range from simple cuts to crush fingertips or amputations. We might do simple repairs, Flaps, Nailbed repairs or Microsurgical reimplants. The decision regarding the type of procedure varies from patient to patient. I prefer options that allow patients to return to work quickly with maximum functionality. Choose your surgeon wisely and with good credentials. Fingertip injuries if not repaired properly may lead to severe handicaps and cosmetic problems.