Late Presentation and Reconstruction of Fingertip Crush Injury in a Child: A Unique Case Report

Volume 7 | Issue 3 | September-December 2021 | Page: —– | Parag Lad, Sanket Tanpure
DOI-10.13107/ijpo.2021.v07i03.—


Authors: Parag Lad [1], Sanket Tanpure [1]

[1] Department of Orthopaedic, Jupiter Lifeline Hospital, Thane, Maharashtra, India.

Address of Correspondence
Dr. Sanket Tanpure,
Department of Orthopaedic, Jupiter Lifeline Hospital, Thane, Maharashtra, India.
E-mail: sankettanpure55@gmail.com


Abstract

Introduction: The fingertip is the most commonly injured part of the hand; therefore, fingertip injuries are among the most frequent injuries that surgeons are required to treat. Crush injuries of the fingertip are typically due to compression by a closing door. We report a late presentation of fingertip crush injury and its management on the dominant little finger in a child.
Case presentation: A 2-year-old male presented with infected and early necrosis of dominant hand little fingertip, caused due to door crush injury. The patient presented at 35 days with an exposed distal phalanx, marginal necrosis and partially healed, ulnarly-placed pulp of the fingertip. The parents of the child were counselled for one attempt of thorough debridement and consideration of pulp adipo-fascial flap repositioning to cover the distal phalanx. Local debridement and trimming of the pulp skin edges were carried out. The ulnarly displaced pulp was repositioned on the tip to cover the distal phalanx and sutured to the radial aspect of the nail fold with absorbable sutures. At 2 years follow up, the injured little finger was normal in cosmesis, function and nail growth.
Conclusion: Healing potential in children is good. Thorough debridement, nailbed and pulp reconstruction to cover the tip of distal phalanx and immobilisation for two weeks help to provide better cosmesis in the form of normal contour of the fingertip and movements, even in late presenting cases.
Keywords: Childhood crush injury, Fingertip, Late presentation, Debridement


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How to Cite this Article:  Tanpure S, Lad P | Late Presentation and Reconstruction of Fingertip Crush Injury in a Child: A Unique Case Report | International Journal of Paediatric Orthopaedics | September-December 2021; 7(3): —–.

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