HAND TRAUMA: CAN THIS FINGER BE SAVED?
No one likes to think about the possibility of losing a finger. But all
too often, I am called to a local emergency room to help save or re-attach
a finger or thumb. Usually the result of an industrial or handyman accident,
these injuries are normally less severe if the patient was wearing protective
gloves. Successful treatment and recovery usually depends on the severity
of the injury, the location of the injury to the hand, and the overall
health of the patient.
In the case of a partial laceration or amputation, the chances of successfully
re-attaching the finger are good if the cut is a clean one with minimal
additional trauma to the digit. ‘Crush’ injuries may damage
a finger to the point where the blood vessels are not viable, making a
A laceration or amputation of the index finger warrants a serious discussion
with the patient. Repairing an injury to zone 2–the area of the
finger between the knuckle and middle joint–often results in severe
stiffness and scarring of the tendons. A great deal of physical therapy
is required to regain functionality after an injury to this area, and
the finger will most likely never be ‘as good as new’. The
reality is that the loss of an index finger often results in a minimal
decrease in function because the other fingers compensate quite well.
Patient and physician need to seriously weigh the cost and benefit of
replanting an index finger.
An injury to the thumb normally warrants the most aggressive course of
treatment because this digit is the most critical to preserving function
of the hand. Unfortunately, the prostheses which are currently available
for the upper extremity have relatively poor functionality since none
restore the sensation which is critical to the use of the hand.
If you or a loved one are at risk of suffering a laceration or amputation
of a digit, keep the following tips in mind:
- Wearing protective gloves can make a big difference in minimizing the severity
of an injury
- In the case of an amputation, the finger should be placed in saline-soaked
gauze, then in a plastic bag with ice
- Treatment will require a full complement of specialists and technology,
so an immediate trip to a well-equipped emergency room is critical—urgent
care centers will probably not be able to handle this emergency
- Recovery will be a long process, with months of physical therapy necessary
to restore functionality. It is not unusual for rehabilitation to go on
over the course of six months to a year.