Nonoperative Management of Distal Fingertip Amputations in Children

摘要: Success with the uncommonly recognized technique of nonoperative management fingertip amputations in children has prompted presentation four cases so treated our institution. Previously, fingertips amputated distal to interphalangeal joint have been observed regenerate under 12 years age.1,2 MATERIAL Our patients were 1, 2, 4, and 9 old. They had injured thumb, middle, index, small fingers, respectively. The levels amputation are seen Fig 1. Three injuries transsected bone. All evaluated for extent injury chosen therapy (Fig 2). wounds cleansed antiseptic solution dressed fine mesh absorbent gauze impregnated bismuth tribromophenate 3% petrolatum blend (Xeroform) sterile bandage. To encourage mobility, no splints used. Dressings changed one week after bi-weekly thereafter. free pain within 24 hours treatment. Healing began at three weeks was completed injury. Good cosmetic functional result regeneration including nail each case 3). DISCUSSION Douglas1 Illingworth2 among early proponents nonsurgical children9s injuries. Despite their well-documented success this treatment, it is not widely practiced. Many3-5 continue advocate reimplantation tip, suture closure, or skin graft flap application stump. However, these techniques should be reserved proximal two phalanges disarticulation where seen.