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Minocqua, WI
A 66-year-old male asked:

Finger avulsion, nail bed intact. distal finger pad tore off, no tendon exposed, no bone fracture. full movement, tx options full thickness graft, leave to heal on own, or amputate proximal to nail bed. risks and recommendations.

3 doctor answers6 doctors weighed in
Dr. Steven Brown
Hand Surgery 40 years experience
Recommend skin graft: Allowing to heal in on its own will take longer time. amputation without bone exposure not indicated. cross finger flap or thenar flap could be best option. Hard to say without visualizing the amputation. full thickness graft results in decreased sensation. Consult hand surgeon
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Edward Hellman
Orthopedic Surgery 30 years experience
Avoid amputation: If you have adequate soft tissue over the bone and tendon, there would be no reason to amputate. A tip without graft will usually gradually fill in, but graft can get quicker coverage. A general rule of thumb is that if area is less than 1 cm in diameter graft not much benefit, if it is quite a bit larger than that then placing a graft on is a consideration.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Jeffrey Wint
Hand Surgery 36 years experience
Skin avulsions: of the fingertip if not exposing significant bone or tendon can heal well secondarily with dressing changes , cosmesis, skin contour , durability and sensation are better with this method than flaps or grafts. Dressing changes alone have many different protocols but the mainstay is to keep clean, and avoid infection. It may take "longer" but the result is better and its just a few weeks
Created for people with ongoing healthcare needs but benefits everyone.
Last updated Sep 19, 2017

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