Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Homodigital island flap
2%
60/3415
Thenar flap
3%
119/3415
Volar flap advancement
6%
188/3415
V-Y advancement flap
23%
787/3415
No change from your initial plan of ointment and dressing
65%
2234/3415
Select Answer to see Preferred Response
In young children with a fingertip amputation, ointment and dressing changes is the most appropriate treatment even if bone is exposed. When deciding on a treatment, consideration of a "reconstruction ladder" is helpful in determining the least invasive procedure to obtain the optimal outcome. The ladder includes primary closure, healing by secondary intention, split-thickness skin grafts, full-thickness skin grafts, random pattern local flaps, axial pattern local flaps, island pattern local flaps, distant random pattern flaps, distant axial pattern flaps, and free tissue transfer. Lamon et al reviewed 25 patients, with an average age of 30 years old, with fingertip injuries treated with dressings and warm soaks started 2 days after injury and noted no healing complications. Only one patient in this cohort had bone exposed. Soderberg et al performed a Level 3 study of 36 operative and 34 conservatively treated fingertip amputations with bone exposure and found no benefit to surgery. Farrell et al conducted a Level 4 review of 21 fingertip amputations with 6 having exposed bone and concluded that they healed with excellent results in regards to contour, sensation, and finger length. Illustration A shows a homodigital island flap. Illustration B shows a thenar flap. Illustration C shows a volar flap advancement. Illustration D shows a volar V-Y flap advancement.
3.4
(30)
Please Login to add comment