Injury & Finger Amputation

Traumatically-amputated fingers

Traumatically-amputated fingers and hands are replanted (reattached) by us routinely and successfully since 1991.

Case Study

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Injury & Finger Amputation

Injury & Finger Amputation Case study 3

Amputation of the fingers, reattached with the help of microvascular surgery. The Surgery is done under massive surgical microscope & successful reattachment requires using stitching

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Blogs

Salvaging a finger

This gentleman sustained an injury to the finger but did not seek any treatment. In the ensuing four months, he had deterioration of the wound

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Finger Tip Injury

Finger tip is the part of the finger close to the nail before the adjacent joint of the finger, it is the commonest injury seen in a hand surgery clinic.

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Cause

It usually follows the finger getting jammed in the door or caught in a machine. The spectrum of fingertip injuries may be confined to just avulsion of the nail plate to amputation of the fingertip.

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Nail is lost

If the nail is avulsed, it is necessary to thoroughly clean the part to eliminate all contamination, eliminate any possibility of infection and then to re position the nail. This step ensures that the new nail grow nicely.

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Fingertip is amputed

The part may be reattached by microsurgery. On other occasions the fingertip is reconstructed. Ultimate aim is to provide length and cosmetically acceptable finger.

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Finger Flap Surgery

An island of skin which has its own blood supply is called a flap. When the skin is lost due to trauma or any other reason and the bone or tendon are exposed or the wound is deep with require a skin cover which has a blood supply. An island of skin which has its own blood supply is called a flap. Certain wounds depending on their location and depth may require flap surgery. While a large number of wounds heal with the passage of time, others require a flap cover. This wound had exposed extensor tendon and was covered with a transposition flap.

Case Study

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Finger Flap Surgery

Finger Flap Surgery Case Study 2

This person was injured, sustained a large wound with the extensor tendons exposed. The wound was covered with a flap. The flap is called posterior

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Slashed Wrist

A sharp weapon or a glass edge can severe the tendons, nerve and the blood supply requiring urgent repair of all the structures. Such an injury is called a slashed wound. A sharp weapon or a glass edge can severe the tendons, nerve and the blood supply requiring urgent repair of all the structures. Sometimes, almost 12 tendons, 2 nerves and 2 arteries can get severed.

Case Study

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Slashed Wrist

Slashed Wrist Case Study 1

Glass injury to the forearm. All 12 tendons which flex the fingers and the wrist are cut; two major nerves which provide sensation to the

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Game Keeper Thumb

It is an injury to the ligament of the thumb due to a fall with the load of the body transmitted to the thumb. Following a fall on the stretched out thumb, the person gets swelling and pain on the inner aspect of the centre of the thumb. A special X-Ray called a stress view is obtained. To get a stress X-Ray view, the injured area is very gently deviated and stress to assess the extent of ligament injury. If the ligament is totally torn, the joint will open out abnormally and will be visible on the X-Ray. This shows abnormal opening on the medial (inner) side of the thumb. There may be a bony avulsion or purely ligament injury. In the normal thumb, the ligament is deep and muscle is superficial. In this condition, the injury causes the ligament to come to lie more superficial to the muscle. This reversal of the location of these structures is called as Stener lesion. This requires surgery to correct the Stener lesion. Special very tiny anchors may be required to fix the avulsion if bone is not of adequate size.

Case Study

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Game Keeper Thumb

Game Keeper Thumb Case Study

Stress view showing abnormal opening of the joint. The straight arrow points at the opening. The curved arrow demonstrate the direction of the stress. Anchors

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Nerve Injury

Nerves are structures which connect hand to the brain. They provides sensation and control the movements of the muscles. When the nerves are cut a person may loose sensation to a certain part of the hand. Or function of a certain muscles may be lost depending on the location of the injury. The nerves are extremely delicate structures.They have to be repaired very early for optimum recovery. With passage of time, the quality of recovery gets poorer and sub-optimal. The repair is done under magnification to match the cut fibers.The repair material is barely visible to naked eyes and measured in microns or repaired with a special glue. The repair is done without any tension at the repair site. With passage of time, the nerve retracts. This means an early repair is the good repair. If the injury is present for quite some time, the nerve will retract. In such a scenario, the gap in the nerve is bridged and grafted with another spare nerve harvested from some other part of the body.

During Treatment

Fall of a glass piece on the forearm of a six years old child. The site of profuse bleeding and shrieking of the child raised an alarm in the family and the neighbourhood. Sharp injury is generally suggestive of nerve injury, hence wound was explored. Sure enough, the Ulnar nerve was found severed.
The Ulnar nerve repaired under microscope.

After
Before
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