Treating Fingertip Amputations

​Fingertip injuries and amputations are common in the emergency department, often occurring on weekends when consultants are not available. Some experienced physicians may consider rongeuring distal tuft amputation injuries, but simple closure and expert consultation for more difficult cases are suggested.A fingertip amputation within zone III involving total amputation of the distal tip, fingernail, matrix, and tuft. Photos by M. Roberts.Care of fingertip amputations in the ED should focus on removing debris and cleaning the wound as best as possible, closing the wound using available skin, bandaging and splinting for comfort, and considering the patient's risk for infection (antibiotics, tetanus update, etc.). It is also vital to control bleeding and provide pain relief. Follow-up with a specialist can usually be done in 24 to 72 hours, depending on the complexity of the wound. Full amputations with the part in hand should be referred immediately for possible reimplantation. Some of these injuries need a thorough washout in an OR or a revision of tendons and bones.Management depends on the severity of the injury, degree of wound contamination, and available resources. (Injury. 2017;48[12]:2643.) Consider the patient's age, comorbidities, occupation, hand dominance, and mechanism of injury.Flap repair in the ED with applied bulky dressing. Photos by M. Roberts.Anatomy of the fingertip. Photo: Lippincott Williams &Wilkins, 2018.Fingertip amputations can be classified in...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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Source: Journal of Strength and Conditioning Research - Category: Sports Medicine Tags: Original Research Source Type: research
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This article discusses the assessment and treatment of patients with LBP, including nonpharmacologic and pharmacologic approaches.
Source: Nursing - Category: Nursing Tags: Feature Source Type: research
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