Hand Surgery

Finger Tip Injuries

The finger tips are very prone to injury. The most common finger tip injuries occur when the finger is caught in a door or cut with a knife. These injuries require expert treatment to ensure that healing occurs in the shortest period of time and with the best result. The finger tip consists of the soft pulp on one side and the nail on the other.

Nail bed injuries

The fingernail is stuck to special skin called the nail bed. Injury to the finger tip often damages the fingernail and underlying skin. Damage to the nail bed causes bleeding, or a 'blood blister' beneath the nail. A large blood blister suggests that there is a significant laceration to the nail bed. This injury requires careful surgical repair. An untreated or poorly treated nail bed injury often leads to abnormal nail growth and this may cause difficulty with the nail catching on things or an unsightly nail. Nail bed repair is a minor operation, and in adult patients is done with local anaesthetic to numb the finger. The damaged nail is removed and the nail bed laceration is meticulously repaired using absorbable stitches. A new nail will usually slowly re-grow.

Pulp injuries and amputation of finger tip

Amputation of the finger tip and loss of skin and tissue from the pulp of the finger are injuries that I frequently see. The treatment depends whether there is bone exposed or not and how much tissue or length of finger tip has been lost. In cases where a small amount of skin (up to about 1cm diameter) has been lost and there is not any bone exposed, the injury is often treated with dressings and will heal very well. If more tissue has been lost or there is exposed bone, surgical treatment is required. The surgical techniques used involve using skin and tissue from the same or neighbouring fingers to cover the wound, or trimming the exposed bone to allow the finger tip wound to be sutured. Fingers that have been completely amputated can in certain cases be reattached (replanted); this is a complex procedure, involving repair of the tiny blood vessels of the finger to restore its blood supply.

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