We retrospectively evaluated 242 fingers of 221 patients who received surgical treatment other than replantation and amputation stump plasty for fingertip amputation resulting from industrial accidents. They were 110 patients with amputation, 85 patients with crushing injury, and 26 patients with defect. The initial surgical procedures for each patient were skin flap coverage for 60 fingers, free complex flap graft for 14 fingers, and composite graft for 21 fingers. For 95 fingers excluding those treated with amputation, procedures were stump plasty (18 patients), replantation (57 patients) and other (72 patients).
The levels of injury by Ishikawa's classification were subzone 1 for 24, subzone 2 for 42, subzones 3 and 4 for 19 fingers, and unknown for 10 patients. The operative procedures for 60 fingers treated with skin flap coverage were oblique triangular flap for 25 fingers, volar advancement flap for 15 fingers, and reverse island flap for 8 fingers.
In fingertip amputation with strong crushing, there is no option such as reconstruction from the beginning and amputation stump plasty is likely to be selected; however, treatment strategy should be examined while keeping in mind that an option such as skin flap coverage, which is functionally and cosmetically satisfactory, is available when the patient desires it.
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