Surgery Book

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Fingertip Amputation

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  1. See also
    1. Finger Laceration
    2. Limb Amputation
  2. Classification
    1. Zone I Fingertip Amputation
      1. Preserved distal phalanx without bone exposure
      2. Majority of nail bed and nail matrix intact
    2. Zone II Fingertip Amputation
      1. Amputation distal to lunula of nail bed
      2. Bony exposure of distal phalanx
    3. Zone III Fingertip Amputation
      1. Loss of entire nail bed
      2. Large portion of distal phalanx lost
  3. Management: General
    1. Anesthesia
      1. See Digital Block
    2. Zone I Fingertip Amputation
      1. Wound left open for Healing by Secondary Intention
      2. Meticulous wound care with close observation
      3. Conservative debridement of excessive granulation
      4. Topical antibiotic ointment for moist wound healing
    3. Zone II Fingertip Amputation
      1. Dorsal Plane Amputation (angled toward finger dorsum)
        1. More nail bed avulsed than pulp
        2. Consider repair with V-Y Plasty
      2. Transverse Plane Amputation (perpendicular to finger)
        1. Equal amounts of nail bed and pulp avulsed
        2. Consider repair with V-Y Plasty
      3. Volar Plane Amputation (angled toward volar finger)
        1. More pulp avulsed than nail bed
        2. Do not use V-Y Plasty for this avulsion
    4. Zone III Fingertip Amputation
      1. Amputate distal phalanx

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