Farooq Azam Khan, Abbas Khan Bajwa, Saqib Raza.
Conservative Management versus Skin Grafting in Fingertip Amputations without Bone Exposure.
J Sharif Med Dent Coll Jan ;4(1):17-20.

Objective: To compare conservative treatment with skin grafting in fingertip amputations without bone exposure. Methodology: It was a randomized control trial conducted at Department of Orthopedic Surgery, Sharif Medical City Hospital, Lahore. The study was approved by the ethical committee of the hospital. Thirty two patients including 6 patients with 2 fingertip injuries were enrolled in the study. The patients were randomly divided into two groups; I and II. Each group included 19 fingertips. The patients in group I and II were managed with dressings and skin grafting respectively. At the end of 3rd & 6th months, they were assessed for defected surface area, average healing time, cold intolerance, infection, hypersensitivity, two-point discrimination, joint stiffness and cosmetic appearance. Results: The mean age of the patients was 26+11 years ranging from 15-55 years. The healing time was 26 days and 15 days in group I and II patients. An average increase in the two-point discrimination distance of 2.85+0.52 mm in group I and 6.56+0.66 mm in group II was reported. In group I, cold intolerance was observed in 6(32%) fingers after 3 months and in 1(5.2%) finger after 6 months. In group II, 9(47.3%) fingers had cold intolerance after 3 months and 3(15.7%) fingers showed cold intolerance after 6 months. Hypersensitivity was not observed in any finger in group I whereas in group II, 11 fingers were hypersensitive after 3 months. Joint stiffness was absent in group I and present in 7 fingers (36.8%) in group II. Cosmetic outcome was good in group I as compared to group II. Conclusion: In fingertip injuries without bone exposure, conservative management is better than surgical interventions. However, in larger defects with bone exposure, skin grafting should be considered. Keywords: Fingertip injuries. Conservative management. Skin grafting

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