Secondary intention healing for fingertip amputation with exposed bone

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2025-09-01 DOI:10.1016/j.hansur.2025.102210

Thai Van Nguyen , Toan Tan Nguyen , Phi Duong Nguyen , Nguyen Tri Phan , Yen Hoang Lam , Khoa Dang Tran , Phat Ngoc Hoang

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Abstract

Purpose

This study aimed to evaluate the outcomes of treating exposed bone fingertip amputations using the secondary intention healing method, and to analyze the correlation between the severity of the injury, as defined by the Allen classification, and the results of the treatment.

Methods

A prospective descriptive study was conducted on 40 patients with fingertip amputation of Allen types 2–4 and exposed bone (≤2 mm) from May 2023 to January 2024. Patients were treated using the secondary intention healing method with a multi-layer moist dressing protocol, which included castor oil, non-adhesive Urgotul gauze, saline-moistened gauze and rubber glove fingertip coverage. The Fingertip Injuries Outcome Score (FIOS) was used to evaluate outcomes after 6 months of follow-up.

Results

The mean age was 32.5 ± 9.27 years, and 82.5% of participants were male. The distribution by Allen classification was as follows: type 2 (50%), type 3 (35%), and type 4 (15%). The mean FIOS score was 15.08 ± 3.10. Excellent results were achieved by 12.5% of patients, good results by 62.5%, and fair results by 25%. FIOS scores increased with injury severity: For Allen types 2, 3 and 4, the scores were 12.80 ± 1.11, 16.14 ± 2.31 and 20.17 ± 1.17, respectively. A strong positive correlation was found between the Allen classification and the FIOS scores (r = 0.80, p < 0.001). The average healing time was 3.95 ± 0.75 weeks. The infection rate was 5%, with 2.5% of cases requiring surgical intervention.

Conclusions

The secondary intention healing method is an effective treatment for exposed bone fingertip amputations, particularly Allen types 2 and 3. Injury severity according to the Allen classification correlates directly with FIOS scores, indicating poorer outcomes for more severe injuries, though these remain within acceptable limits.

Level of evidence

Level IV, Case Series.

查看原文本刊更多论文

外露骨指端截肢的二次意向愈合。

目的：本研究旨在评价采用二次意向愈合法治疗外露骨指端截肢的效果，并分析Allen分类定义的损伤严重程度与治疗结果的相关性。方法：对2023年5月至2024年1月40例Allen 2-4型指端截肢及暴露骨（≤2mm）患者进行前瞻性描述性研究。患者采用二次意向愈合法，采用多层湿敷料方案，包括蓖麻油、无粘Urgotul纱布、盐湿纱布、橡胶手套指尖覆盖。采用指尖损伤结局评分（FIOS）评估随访6个月后的结果。结果：平均年龄32.5±9.27岁，男性占82.5%。按Allen分类分布为2型（50%）、3型（35%）、4型（15%）。平均FIOS评分为15.08±3.10。优良率为12.5%，良率为62.5%，尚可率为25%。FIOS评分随损伤程度的增加而增加，Allen 2、3、4型评分分别为12.80±1.11、16.14±2.31、20.17±1.17。Allen分型与FIOS评分呈显著正相关（r = 0.80, p）。结论：二次意向愈合法是外露骨指端截肢的有效治疗方法，尤其是Allen 2型和3型。根据Allen分类，损伤严重程度与FIOS得分直接相关，表明更严重的损伤预后较差，尽管这些仍在可接受的范围内。证据等级：四级，案例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.