Detachment of the first toe or big toe from the rest of the foot.
This can be caused by trauma or as a result of elective surgery.
If the amputation is surgical, the blood vessels are sutured to prevent bleeding before the bone and muscle are cut. The most common causes are conditions that cause poor circulation, such as diabetes, tumours, deformities, infections and/or gangrene.
If the amputation is caused by trauma, the bleeding and tissue loss is usually greater. When a limb is torn off or avulsed, the bleeding can be massive and the surgical repair very difficult. The most common causes include car accidents, industrial accidents and war injuries.
The elective treatment is surgical and its main objective is to save the finger if possible and to avoid its bleeding and infection. Severe cases can lead to the death of the patient if not controlled.
In cases of traumatic amputation, direct compression can be used to reduce bleeding until surgery is performed. Once the amputated finger and stump have been properly treated, reattachment can be considered in a specialist centre.
- 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.
