Fingertip Injuries

Fingertip injuries are the most common workplace injuries. These are usually due to crushing by tools or machine parts.

Nailbed injuries

The finger nail is supported by the nailbed. When it is injured, there is a risk of poor healing causing the nail to become deformed and painful, making it difficult to use the finger properly at work. A proper nail bed repair allows optimal healing and a good nail to grow back.

1

2

Severe nailbed injuries from grinding machine. These need to be repaired meticulously. The hard fingernail is removed to repair the nailbed and replaced over the repair if it is not broken. If the nail is damaged, an artificial nail is placed over the repair to protect the nailbed while the new nail grows.

Distal phalanx fractures

The distal phalanx is the bone in the finger tip. A stable distal phalanx is needed to for proper finger function and nail growth. While most distal phalanx fractures do not need to be fixed, some do. They can be very complex with many fragments that need to be joined together properly. Badly fixed fractures will not heal well, causing a lot of pain and delaying return to work.

3

3

Badly crushed finger tip with complex fracture. The nailbed, skin and bone must all be repaired and fixed meticulously.

Fingertip amputation

Part or all of the fingertip can be amputated by the injury, resulting in a shortening of the finger and disability. To minimize this disability, the fingertip should be reconstructed to preserve as much length and nail as possible. Reconstruction is done by moving skin from the rest of the finger or from another finger to cover the exposed bone. If done properly, a fingertip with good function can be restored in most cases. Occasionally, it is impossible to reconstruct the fingertip. In these cases, reconstruction is aimed at preserving as much length as possible while creating a good stump that is not painful.

3

3

Finger tip amputations. Skin from the same finger is moved forward to cover the exposed bone and reconstruct the tips. Alternatively, skin from the back of the finger next to the injured one can be used.

Rehabilitation

Most fingertip injuries are painful and tender for several weeks or months because many nerve endings are injured. Rehabilitation with a special desensitization programme and adequate medication for pain minimizes the time taken for the pain to decrease sufficiently to allow return to normal work. Attention is also given to keeping the finger joints moving to prevent stiffness, as patients tend not to move the finger if it is painful.