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Fingertip Injuries Clinical Presentation

  • Author: Glen Vaughn, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
Updated: Sep 23, 2015


Ascertain the following information when gathering patient history:

  • Mechanism of injury
  • Hand dominance
  • Occupation and hobbies
  • Length of time since injury
  • Tetanus immunization status


Evaluate the fingertip injury to determine the following:[2]

  • Crush versus sharp injuries
  • Nail or nail bed involvement
  • Bone involvement
  • Viability of tip
  • Presence of foreign body
Contributor Information and Disclosures

Glen Vaughn, MD Director, Department of Emergency Medicine, Defiance Hospital

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Eric L Legome, MD Chief, Department of Emergency Medicine, Kings County Hospital Center; Professor Clinical, Department of Emergency Medicine, State University of New York Downstate College of Medicine

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, Council of Emergency Medicine Residency Directors, American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Jeffrey Glenn Bowman, MD, MS Consulting Staff, Highfield MRI

Disclosure: Nothing to disclose.

  1. Chang J, Vernadakis AJ, McClellan WT. Fingertip injuries. Clin Occup Environ Med. 2006. 5(2):413-22, ix. [Medline].

  2. Lemmon JA, Janis JE, Rohrich RJ. Soft-tissue injuries of the fingertip: methods of evaluation and treatment. An algorithmic approach. Plast Reconstr Surg. 2008 Sep. 122(3):105e-117e. [Medline].

  3. Mennen U, Wiese A. Fingertip injuries management with semi-occlusive dressing. J Hand Surg [Br]. 1993 Aug. 18(4):416-22. [Medline].

  4. Mühldorfer-Fodor M, Hohendorff B, Vorderwinkler KP, van Schoonhoven J, Prommersberger KJ. [Treatment of fingertip defect injuries with a semiocclusive dressing according to Mennen and Wiese]. Oper Orthop Traumatol. 2013 Feb. 25(1):104-14. [Medline].

  5. Williamson DM, Sherman KP, Shakespeare DT. The use of semipermeable dressings in fingertip injuries. J Hand Surg [Br]. 1987 Feb. 12(1):125-6. [Medline].

  6. Ha NB, Chang AC, Sullivan JS, Leonello DT. Non-operative management of fingertip injuries with an intravenous dressing. J Wound Care. 2015 Jun. 24 (6):276, 278-9. [Medline].

  7. Gellman H. Fingertip-nail bed injuries in children: current concepts and controversies of treatment. J Craniofac Surg. 2009 Jul. 20(4):1033-5. [Medline].

  8. Li J, Guo Z, Zhu Q, Lei W, Han Y, Li M. Fingertip replantation: determinants of survival. Plast Reconstr Surg. 2008 Sep. 122(3):833-9. [Medline].

  9. Zhou X, Xu Y, Rui Y, Yao Q. [Investigation of new classification and repair methods for fingertip traverse amputation]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Sep. 22(9):1089-91. [Medline].

  10. Zhang X, Shao X, Ren C, Zhang Z, Wen S, Sun J. Reconstruction of thumb pulp defects using a modified kite flap. J Hand Surg Am. 2011 Oct. 36(10):1597-603. [Medline].

  11. Eberlin KR, Busa K, Bae DS, Waters PM, Labow BI, Taghinia AH. Composite grafting for pediatric fingertip injuries. Hand (N Y). 2015 Mar. 10 (1):28-33. [Medline].

  12. Peterson SL, Peterson EL, Wheatley MJ. Management of fingertip amputations. J Hand Surg Am. 2014 Oct. 39 (10):2093-101. [Medline].

  13. Muck AE, Bebarta VS, Borys DJ, Morgan DL. Six years of epinephrine digital injections: absence of significant local or systemic effects. Ann Emerg Med. 2010 Sep. 56(3):270-4. [Medline].

  14. Rubin G, Orbach H, Rinott M, Wolovelsky A, Rozen N. The use of prophylactic antibiotics in treatment of fingertip amputation: a randomized prospective trial. Am J Emerg Med. 2015 May. 33 (5):645-7. [Medline].

  15. Adani R, Marcoccio I, Tarallo L. Treatment of fingertips amputation using the Hirase technique. Hand Surg. 2003 Dec. 8(2):257-64. [Medline].

  16. Almquist EE. Hand injuries in children. Pediatr Clin North Am. 1986 Dec. 33(6):1511-22. [Medline].

  17. Brown RE. Acute nail bed injuries. Hand Clin. 2002 Nov. 18(4):561-75. [Medline].

  18. Browne EZ. Complications of fingertip injuries. Hand Clin. 1994 Feb. 10(1):125-37. [Medline].

  19. de Alwis W. Fingertip injuries. Emerg Med Australas. 2006 Jun. 18(3):229-37. [Medline].

  20. Evans DM, Bernardis C. A new classification for fingertip injuries. J Hand Surg [Br]. 2000 Feb. 25(1):58-60. [Medline].

  21. Hart RG, Kleinert HE. Fingertip and nail bed injuries. Emerg Med Clin North Am. 1993 Aug. 11(3):755-65. [Medline].

  22. Hirase Y. Salvage of fingertip amputated at nail level: new surgical principles and treatments. Ann Plast Surg. 1997 Feb. 38(2):151-7. [Medline].

  23. Inglefield CJ, D'Arcangelo M, Kolhe PS. Injuries to the nail bed in childhood. J Hand Surg [Br]. 1995 Apr. 20(2):258-61. [Medline].

  24. Ipsen T, Frandsen PA, Barfred T. Conservative treatment of fingertip injuries. Injury. 1987 May. 18(3):203-5. [Medline].

  25. Kim WK, Lim JH, Han SK. Fingertip replantations: clinical evaluation of 135 digits. Plast Reconstr Surg. 1996 Sep. 98(3):470-6. [Medline].

  26. Lee LP, Lau PY, Chan CW. A simple and efficient treatment for fingertip injuries. J Hand Surg [Br]. 1995 Feb. 20(1):63-71. [Medline].

  27. Macgregor DM, Hiscox JA. Fingertip trauma in children from doors. Scott Med J. 1999 Aug. 44(4):114-5. [Medline].

  28. Martin C, Gonzalez del Pino J. Controversies in the treatment of fingertip amputations. Conservative versus surgical reconstruction. Clin Orthop. 1998 Aug. (353):63-73. [Medline].

  29. Muneuchi G, Tamai M, Igawa K, et al. The PNB classification for treatment of fingertip injuries: the boundary between conservative treatment and surgical treatment. Ann Plast Surg. 2005 Jun. 54(6):604-9. [Medline].

  30. Pasapula C, Strick M. The use of chloramphenicol ointment as an adhesive for replacement of the nail plate after simple nail bed repairs. J Hand Surg [Br]. 2004 Dec. 29(6):634-5. [Medline].

  31. Roser SE, Gellman H. Comparison of nail bed repair versus nail trephination for subungual hematomas in children. J Hand Surg [Am]. 1999 Nov. 24(6):1166-70. [Medline].

  32. Russell RC, Casas LA. Management of fingertip injuries. Clin Plast Surg. 1989 Jul. 16(3):405-25. [Medline].

  33. Shabat S, Sagiv P, Stern A, Nyska M. Polyurethane film (opsite) for superficial fingertip avulsion injuries. Plast Reconstr Surg. 2000 Aug. 106(2):512. [Medline].

  34. Stanislas JM, Waldram MA. Keep the nail plate on with Histoacryl. Injury. 1997 Oct. 28(8):507-8. [Medline].

  35. Stevenson TR. Fingertip and nailbed injuries. Orthop Clin North Am. 1992 Jan. 23(1):149-59. [Medline].

  36. Tos P, Titolo P, Chirila NL, Catalano F, Artiaco S. Surgical treatment of acute fingernail injuries. J Orthop Traumatol. 2012 Jun. 13(2):57-62. [Medline]. [Full Text].

  37. van den Berg WB, Vergeer RA, van der Sluis CK, Ten Duis HJ, Werker PM. Comparison of three types of treatment modalities on the outcome of fingertip injuries. J Trauma Acute Care Surg. 2012 Jun. 72(6):1681-7. [Medline].

  38. Venkatramani H, Sabapathy SR. Fingertip replantation: Technical considerations and outcome analysis of 24 consecutive fingertip replantations. Indian J Plast Surg. 2011 May. 44(2):237-45. [Medline].

  39. Weichman KE, Wilson SC, Samra F, Reavey P, Sharma S, Haddock NT. Treatment and outcomes of fingertip injuries at a large metropolitan public hospital. Plast Reconstr Surg. 2013 Jan. 131(1):107-12. [Medline].

Significant nailbed injuries can occur from nail root avulsions.
Removal of the nail plate with iris scissors.
Suturing of a nailbed laceration.
Sutured nailbed injury.
U-stitch method of securing the nail plate.
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