Fingertip Injuries

Overview :

The fingertips are specialized areas of the hand with highly developed sensory and manipulative functions. Large sensory and motor areas located in the brain regulate the precise and delicate functions of fingertips. The fingertip is the site where extensor and flexor tendons insert. Fingertip injuries are extremely common since the hands hold a wide array of objects. In 2001, the approximately 10% of all accidents in the United States referred for Emergency Room consults involve the hand. Hand injuries are frequently the result of job injuries and account for 11-14% of on-the-job injuries and 6% of compensation paid injuries. Injury to the nail bed occurs in approximately 15-24% of fingertip injuries.

Fingertip injuries can result in amputation or tissue loss. The injury is assessed whether the bone and underlying tissue are intact and the size of the wound area. The pulp is the area of skin opposite the fingernail and is usually very vulnerable to injury. Pulp injuries commonly occur in persons who use or are in close contact with fast moving mechanical devices. These injuries can crush, cut, and puncture. The fingertips can also be injured by common crushing accidents. This could cause the development of a subungal hematoma (an accumulation of blood under the nail). At the base of the distal phalanx (the first circular skin fold from the tip) injuries can occur that can fracture the underlying bone in the area. Quite commonly a hammer, closing a door, or sport accidents usually cause these injuries. These fractures can be simple, requiring little treatment or more complicated involving the joint. The accident may involve the point of insertion of a tendon. Usually this occurs when the terminal joint is being forced to flex while held straight. This motion typically occurs when tucking in sheets during bed making, a common cause of tendon injury. This injury causes a loss of extension (straightening the finger) ability.