Digit Amputations

Abstract

Digital amputation is often associated with traumatic injuries but is also seen within the elective surgery setting, such as cancer resection and management of chronic conditions such as Dupuytrens contractures or peripheral vascular disease. It is also seen as a consequence of severe sepsis, although this often results in auto-amputation.  In the traumatic setting, the primary objective of management is to salvage the amputated finger to restore function, especially if the dominant hand is affected. However, this is not always possible, as there are many factors to consider. These factors include the time from injury, mechanism of injury, and degree of contamination [1]. In the elective setting, determinants for the level of amputation include various factors, such as oncological clearance, symptom relief, and function preservation; however, for the purpose of this paper, the primary focus will be on a traumatic finger amputation. The basic goal in the treatment of digit amputations (especially upper limb) includes: Preservation of functional length. Durable coverage. Preservation of useful sensibility. Prevention of symptomatic neuromas. Prevention of adjacent joint contractures. Early return to work. Early prosthetic fitting.