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Fingertip Amputation: Background, Indications, Contraindications

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Fingertip Amputation
Author: Palaniappan Lakshmanan, MBBS, MS, AFRCS, FRCS(Tr&Orth); Chief Editor: Erik D Schraga, MD
more...
Updated: Nov 18, 2015

Technical Considerations
Anatomy
The basic skeleton of the wrist and hand comprises a total of 27 bones. The hand is
innervated by three nervesthe median, ulnar, and radial nerveseach of which
has sensory and motor components. The muscles of the hand are divided into
intrinsic and extrinsic groups.
The hand contains 14 phalanges. Each digit contains three phalanges (proximal,
middle, and distal), except for the thumb, which only has two phalanges. To avoid
confusion, each digit is referred to by its name (thumb, index, long, ring, and small)
rather than by number.
The nails are specialized skin appendages derived from the epidermis. The nail bed
has a germinal matrix, sterile matrix, and hyponychium. Ninety percent of the nail
plate is produced by the germinal matrix, which approximately corresponds to the
lunula (pale semicircle in proximal nail bed). This germinal matrix starts proximally at
the base of the distal phalanx just distal to the insertion of the extensor tendon.
The entire nail matrix is in intimate contact with the periosteum of the distal phalanx;
therefore, it is vulnerable to injury when the latter is fractured.
For more information about the relevant anatomy, see Hand Anatomy.
Periprocedural Care

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Fingertip Amputation: Background, Indications, Contraindications

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Contributor Information and Disclosures


Author
Palaniappan Lakshmanan, MBBS, MS, AFRCS, FRCS(Tr&Orth) Consultant Spinal Surgeon, Department of
Trauma and Orthopaedics, Sunderland Royal Hospital, UK
Palaniappan Lakshmanan, MBBS, MS, AFRCS, FRCS(Tr&Orth) is a member of the following medical societies:
British Orthopaedic Association, AOSpine
Disclosure: Nothing to disclose.
Coauthor(s)
Sukhvans Sandhu, MBChB Spinal Senior House Officer, The Centre for Spinal Studies and Surgery, Queens
Medical Centre, UK
Sukhvans Sandhu, MBChB is a member of the following medical societies: British Medical Association, Royal
Society of Medicine
Disclosure: Nothing to disclose.
Specialty Editor Board
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of
Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Laurie Scudder, DNP, NP Nurse Planner, Medscape; Senior Clinical Professor of Nursing, George Washington
University
Disclosure: Nothing to disclose.
Chief Editor
Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical
Associates
Disclosure: Nothing to disclose.
Additional Contributors
Joseph U Becker, MD Fellow, Global Health and International Emergency Medicine, Stanford University School
of Medicine
Joseph U Becker, MD is a member of the following medical societies: American College of Emergency
Physicians, Phi Beta Kappa, Society for Academic Emergency Medicine, Emergency Medicine Residents'
Association
Disclosure: Nothing to disclose.

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Fingertip Amputation: Background, Indications, Contraindications

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Acknowledgements
The author acknowledges the work of Mrs. Unnamalai Lakshmanan in helping typeset the article.

References
1. Fassler PR. Fingertip Injuries: Evaluation and Treatment. J Am Acad Orthop Surg. 1996 Jan. 4(1):84-92.
[Medline].
2. Panattoni JB, De Ona IR, Ahmed MM. Reconstruction of fingertip injuries: surgical tips and avoiding
complications. J Hand Surg Am. 2015 May. 40 (5):1016-24. [Medline].
3. Macht SD, Watson HK. The Moberg volar advancement flap for digital reconstruction. J Hand Surg [Am].
July 1980. 5(4):372-6. [Medline].
4. Yam A, Peng YP, Pho RW. "Palmar pivot flap" for resurfacing palmar lateral defects of the fingers. J Hand
Surg [Am]. Dec 2008. 33(10):1889-93. [Medline].
5. Omokawa S, Fujitani R, Dohi Y, Tanaka Y, Yajima H. Reverse midpalmar island flap transfer for fingertip
reconstruction. J Reconstr Microsurg. 2009 Mar. 25(3):171-9. [Medline].
6. Ozyigit MT, Turkaslan T, Ozsoy Z. Dorsal V-Y advancement flap for amputations of the fingertips. Scand J
Plast Reconstr Surg Hand Surg. 2007. 41(6):315-9. [Medline].
7. Rubin G, Orbach H, Rinott M, Wolovelsky A, Rozen N. The use of prophylactic antibiotics in treatment of
fingertip amputation: a randomized prospective trial. Am J Emerg Med. 2015 May. 33 (5):645-7. [Medline].
Medscape Reference 2011 WebMD, LLC

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