Separation of the fourth toe from the rest of the foot.
The cause is usually traumatic although it may be secondary to elective surgery.
When amputation is performed in the context of surgery, blood vessels are ligated to prevent bleeding before cutting tissue and cartilage. The most frequent causes are diseases that cause poor blood circulation, tumors, deformities, infections and/or gangrene.
When the amputation occurs in the context of trauma, bleeding and tissue loss is usually greater. If there is a tearing up of the limb or avulsion, the bleeding can be massive and the surgical repair very difficult. The most frequent causes are traffic accidents, workplace accidents and war wounds.
The treatment of choice is surgical; its priority is to save the toe if possible and avoid bleeding and infection. Severe cases can lead to the death of the patient if they are not controlled.
In cases of traumatic amputation, direct compression can be used to stop the bleeding until surgical assessment. If the amputated limb and the stump receive the appropriate care, its reattachment in a specialized center can be assessed.
- Antevy, PM, Saladino, RA. Management of finger injuries. In: Textbook of Pediatric Emergency Procedures, 2nd edition, King, C, Henretig, FM (Eds), Lippincott, Williams & Wilkins, Philadelphia 2008. p.939.
- de Alwis W. Fingertip injuries. Emerg Med Australas 2006; 18:229.
