Separation of the first finger or thumb from the rest of the hand.
The cause is usually traumatic, although it can be secondary to elective surgery.
When amputation is performed during surgery, blood vessels are tied off to prevent bleeding before tissue and cartilage is cut away. The most common causes are diseases that cause poor circulation, tumours, deformities, infections and/or gangrene.
If the amputation is due to trauma, there is usually more bleeding and tissue loss. If the finger is torn or avulsed, the bleeding can be massive and surgical repair very difficult. The most common causes are road traffic accidents, industrial accidents and war injuries.
The treatment of choice is surgical and the priority is to save the finger if possible and to prevent bleeding and infection. Severe cases can be fatal if not controlled.
In cases of traumatic amputation, direct compression can be used to stop bleeding until surgical revision. With appropriate care of the amputated finger and stump, 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.
- Lee DH, Mignemi ME, Crosby SN. Fingertip injuries: an update on management. J Am Acad Orthop Surg 2013; 21:756.
- Fetter-Zarzeka A, Joseph MM. Hand and fingertip injuries in children. Pediatr Emerg Care 2002; 18:341.?
