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Primary wound closure
12%
111/903
Revision amputation with primary wound closure
6%
52/903
Local wound care alone
69%
624/903
V-Y flap advancement flap
11%
103/903
Digital island artery flap
1%
8/903
Select Answer to see Preferred Response
Fingertip injuries with no exposed bone and <2 cm of soft tissue loss can be treated with healing by secondary intention. Fingertip injuries without exposed bone and <2 cm of soft tissue loss can often be treated conservatively. Initial treatment typically involves cleaning the wound, stopping any bleeding, and immobilizing the injured finger. Antibiotic therapy may be prescribed to prevent infection. Depending on the severity of the injury, the wound may be closed with sutures or left to heal on its own. A splint may be applied to protect the wound during the acute healing process. Physical therapy may be recommended to improve the range of motion and prevent scarring after the wound has epithelialized. Flaps, soft tissue advancements, or revision amputation with primary closure may be required in cases where there is exposed bone or significant soft tissue defect (>2 cm). Thenar flaps are associated with excessive long-term finger stiffness, which makes this option less desirable. Fassler reviewed the evaluation and treatment of fingertip injuries. The author stated that for soft-tissue loss with no exposed bone, secondary healing or skin grafting is used, whereas, in the setting of exposed bone and sufficient nail matrix, a local advancement flap is considered. The author further recommended a regional flap or shortening with primary closure if the angle of amputation does not permit local flap coverage. Peterson et al. reviewed the treatment of fingertip amputations. The authors stated different treatment options are available, but there is no consensus on the best approach. The authors concluded that the goal of treatment is to minimize pain, optimize healing time, preserve sensibility and length, prevent painful neuromas, minimize time lost from work, and provide an acceptable cosmetic appearance. Incorrect answers Answers 1, 2, 4, and 5: Fingertip injuries that have no exposed bone and <2 cm of soft tissue defect can be treated with local wound care and healing by secondary intention.
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