Fingertip accidents are commonplace amputations at home or on the job. Fingertips can slam in doors, in car doors, while chopping food or when clearing out a lawnmower or snowblower. These types of injuries can involve crushing of the fingertip, tearing of the fingertip or cutting off of the fingertip, including the thumb. The nailbed, soft tissue and bone (phalanx) can be involved in the injury. The tips of the fingers are injured more commonly than the rest of the finger because they are the least likely to escape harm’s way.
These types of amputations are very painful because there are a lot of nerves in the area. They also tend to bleed quite a lot due to a rich blood supply. When an amputation happens, you should elevate the stump and cover the wound with a sterile dry dressing. Apply pressure if needed. If there is a part of the finger that is cut off, it should be wrapped in a moist sterile gauze and placed in a baggie. You should then place the baggie in some ice water. Don’t put the amputated part directly on ice and do not use dry ice to keep the amputated part cold.
At the hospital, the doctor will likely do a digital block to numb the finger. The wound will be flushed out completely with any devitalized tissue trimmed off. If the amputated finger is vital enough to be reattached, it is reattached to the stump. If the finger has taken too long to be reattached, approximately 16 hours or more, then the stump will be closed with skin and the finger will be considered an amputated finger. Because there is a high chance of infection, preventative antibiotics are given to keep the wound free of infection.
If the injury has occurred without exposed bone, it may heal on its own with simply a protective dressing on the bandage and frequent bandage changes. If the loss of tissue is large enough to expose bone, the bone may need to be shortened so as to allow skin to cover the ends of the amputated bone. A flap surgery can be done using skin, fat and blood vessels harvested from another part of the hand on the same side.
Risks of reattachment surgery include loss of feeling or motion of the affected finger, poor healing of the affected finger, infection of the wound and adverse reactions to anesthesia.
Some interesting things can happen with finger amputations and motor vehicle accidents. An adult male stated that he was driving with his left index finger in a hole on the spoke of his steering wheel. He struck a tree and the finger was severed. Upon inspection, the finger was neatly severed at the midshaft of the finger and was said to have happened due to the inertia of the spinning wheel at the time of the crash. Laboratory tests were done to see exactly how such an injury could have happened using cadaver fingers.
The laboratory analysis showed that there could be no possible way that the forces of the crash could have caused the finger amputation and it was felt that the amputation was simply just too clean. In the end, it was determined that the injury was self-inflicted instead of accidental and no automobile claim was made.