Résumé
Fingertip injuries are the most common hand injuries in adults and children.
The distal phalanx is divided into base, shaft, and tuberosity or tuft.
Fibrous septae connect the skin to the tuft and provide support for the finger pulp.
Treatment can vary from drainage of a subungual hematoma to nail bed sutures, to osteosynthesis of the distal phalanx, and flaps to tissue loss of the distal pulp.
Treating subungual hematomas depends on the intensity of the trauma. Bruises that involve up to 50% of the nail bed present with severe pain and must be drained in sterile conditions. When the germinal matrix is involved, the nail must be elevated to allow suturing of the nail bed. When the nail bed is torn away, it must be repositioned to achieve anatomical reconstruction of the nail complex.
Flaps are effective options in post-traumatic finger reconstruction. The choice of the type of skin flap must consider the location, type of trauma, and the surgeon’s own experience.
The main goals of preservation of function and establishing a stable and sensitive fingered grip.