Fingertip Injuries in Children

Abstract

Fingertip injuries are common in children, accounting for approximately two thirds of all pediatric hand injuries. Children of all ages suffer from hand trauma; however, fingertip injuries most frequently occur in young children. Fingertip and nail bed damage can lead to long-term cosmetic consequences, which can adversely affect hand function. The goal of treatment is to provide adequate padding and maintain the length of the digit. Treatment of these injuries is varied, and includes healing by secondary intention, shortening of the bone, and primary closure and coverage by local or regional skin flap. Ultimate treatment decisions should be tailored to the individual patient based on the size and extent of the wound; the presence of exposed bone, tendon, or neurovascular structures; the degree of wound contamination; the availability of soft-tissue coverage using local or remote sources; and the sophistication and ability of the patient and family to comply with postoperative instructions. An experienced hand surgeon should treat complex fingertip injuries requiring replantation and flap coverage.

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