Traumatic finger amputation

Case contributed by Andrew Murphy
Diagnosis certain

Presentation

Man vs. circular saw

Patient Data

Age: 60 years
Gender: Male

Initial imaging

x-ray

There is a traumatic amputation of the left ring finger that is disarticulated to the level of the proximal interphalangeal joint. 

There is also a traumatic amputation of the left little finger at the mid shaft of the middle phalanx. 

An avulsion can be seen arising from the base of the proximal phalanx left little finger.

Follow up imaging

x-ray

The surgical screws and plates stabilize the middle phalanx of the little finger in place.  No complication is seen in relation to the metalware.  There is minor subluxation in the distal interphalangeal joint of the little finger.  Proximal interphalangeal joint prosthesis is noted in place involving the ring finger.  There is diffuse osteopenic change in the bones likely to be related to disuse.

Case Discussion

The decision to perform digital replantation after traumatic amputation is made after considering a variety of factors including function, revascularization, quality of life, and chances of a successful replantation must be considered.

One of the key factors that will influence the success of a replanted digit, was if venous anastomosis is necessary.

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