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指尖损伤

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Crush, laceration, nail-bed and amputation injuries of the fingertip and their management.

Updated Aug 2026
一幅手绘的受伤指尖插图。
锤状指——指尖下垂，因为手指末端的伸肌腱撕裂或撕脱了一小块骨片。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会注意到指尖出现剧烈疼痛。这通常发生在有切割伤、挤压伤或部分截肢的情况下。疼痛起初可能非常剧烈，尤其是当骨骼暴露时。您可能还会感到搏动性或钝痛，导致夜间难以入睡。

指尖富含神经末梢，因此即使是小伤口也会感觉异常疼痛。触碰该区域或使其碰撞到物体可能会加重疼痛。您可能会发现难以用手完成日常任务。简单的动作，如打字、拿杯子或扣衬衫纽扣，可能会变得困难。如果损伤涉及甲床，您可能会看到出血，或注意到指甲松动或缺失。

如果您患有血管球瘤，您可能会对寒冷或轻触产生极度敏感。这种疼痛可能是突然且剧烈的。您可能会避免接触某些温度或质地。

在严重损伤的情况下，您可能会担心手指的外观。肿胀和瘀伤很常见。如果存在骨质丢失，您可能会注意到指尖看起来变短或变形。这可能导致“钩状甲”畸形，即指甲向下生长。

尽管存在疼痛，但感染风险很低，远端指尖感染的感染率仅为 2.5%。您不一定需要预防性抗生素，因为研究表明，无论是否使用抗生素，感染率没有显著差异。然而，保持伤口清洁至关重要。

如果您有挤压伤或截肢，愈合时间会有所不同。通过专门的超声治疗，愈合速度可以比仅进行局部伤口护理快九倍。对于修复性截肢，您预计大约 7 周后可以恢复工作。

您的外科医生旨在恢复功能和外观。这意味着要减轻疼痛、保留感觉并保持手指长度完整。无论是通过简单的换药还是手术皮瓣，目标都是帮助您恢复手的正常功能。

实际发生了什么

您的指尖是皮肤、骨骼和甲母质的复杂组合。甲母质是指甲襞下方的根部，负责生成新的指甲细胞。它位于指骨末端附近。当您遭受挤压伤或截肢时，会损伤这种敏感组织。治疗的目标是保护该区域，以便其能够正确愈合。

您可能会担心感觉丧失或长度缩短。然而，保守治疗通常效果良好。即使骨骼暴露，在许多情况下您的身体无需手术即可愈合。如果需要手术，修复性截肢术可以恢复近乎正常的感觉和运动功能。您通常可以在大约七周内重返工作岗位。

我们提供多种重建指尖的方法。某些方法使用来自邻近区域的皮肤和组织瓣。这些方法提供即时覆盖。其他方法则使用来自您自身甲床或供体材料的移植。这些有助于恢复指甲的形状和功能。您的外科医生会根据您的具体损伤选择最佳方案。

此类损伤后感染罕见，发生率仅为 2.5%。由于该比率较低，抗生素并非总是必要。某些治疗，如特殊的超声波疗法，可以显著加速愈合。它们的工作速度可能比单独的标准伤口护理快九倍。

主要目标是最大限度地减少疼痛并保持手指的长度。我们还专注于保留您感知纹理和抓握物体的能力。外观也很重要，因为许多患者希望拥有外观自然的指甲。没有一种标准方法适用于所有损伤。我们根据您的需要定制计划，平衡愈合速度与长期功能。

我们能做什么

基兰·希尔帕拉（Kieran Hirpara）医生在 Mater Private Hospital Rockhampton 担任上肢外科医生，他在我们诊所采取的方法反映了我们处理此类损伤的方式。我们从侵入性最小的选项开始。对于许多指尖损伤，保守的非手术治疗效果良好。这包括无需手术的简单伤口护理。如果您有骨骼暴露，我们仍会评估非手术治疗对您是否安全。这些损伤后的感染率仅为 2.5%。由于风险较小，我们不会常规开具预防性抗生素。如果愈合缓慢，我们可能会使用非接触式低频超声波治疗。与仅进行局部伤口护理相比，这种治疗可将愈合速度提高九倍。

我们专注于保持您手指的功能性和舒适度。您可以使用常规止痛药来管理疼痛。如果药物没有帮助，我们会避免使用不必要的药物。对于部分患者，我们会使用夹板在愈合期间保护该区域。人工指甲可作为甲床修复的夹板。这有助于您在主指关节恢复 80 度的活动度，在中指关节恢复 85 度的活动度，在指尖关节恢复 30 度的活动度。该方法在 18 个月后显示出无复发性感染的证据。我们的目标是保留您的感觉和手指长度。我们的目标是恢复一个外观和触感自然的令人满意的指尖。

当保守治疗未能带来足够的改善或损伤严重时，会考虑手术。我们可能会使用皮瓣或移植来覆盖伤口并恢复指甲。技术包括使用来自附近区域的皮肤皮瓣或从手掌移植组织。这些手术旨在最大限度地减少疼痛，优化愈合，并提供可接受的 cosmetic 外观。在某些情况下，我们可能会进行修订性截肢术。这会使手指略微缩短，但可以实现近乎正常的感觉和令人满意的活动度。患者预计在此手术后平均约 7 周可重返工作岗位。我们会与您讨论所有选项，以找到最适合您特定损伤的最佳路径。

预期情况

您的指尖血供丰富，通常有助于良好愈合。许多轻微损伤通过简单护理即可恢复。您可以选择保守治疗，让伤口自行愈合。即使有骨骼暴露，这种方法也可能取得成功。对于部分患者，非接触式低频超声治疗可加速愈合。其恢复速度可比单纯局部伤口护理快九倍。

如需手术，您的外科医生旨在恢复功能与外观。具体技术因您的损伤类型而异。皮瓣和植皮术常用于覆盖暴露区域并保护甲床。这些方法有助于预防指尖缩短或指甲形态异常。此类术后感染并不常见，发生率约为 2.5%。您并非总是需要预防性抗生素，因为风险仍然较低。

恢复过程因治疗路径不同而有所差异。如果您接受截指修整术，预计约 7 周后可重返工作岗位。感觉和运动功能通常会有显著改善，接近正常水平。对于甲床修复，您可能需要使用简单的人工指甲夹板。这可在关节愈合期间提供支撑。大多数患者在 18 个月时未出现感染复发的迹象。

对于成人的切割伤，复合移植术可提供极佳疗效。如果在受伤后 5 小时内进行手术且患者不吸烟，成功率最高。对于老年患者，皮瓣重建通常是维持活动度的最佳初始选择。您的外科医生将讨论哪种方案适合您的生活方式和损伤类型。目标始终是最大限度地减少疼痛、保留长度，并为您提供功能正常的指尖。

何时就诊

若休息后疼痛仍持续不缓解，请咨询全科医生。若出现无力、不稳，或手指出现交锁/卡顿现象，请要求专科医生评估。若症状影响睡眠或工作，请及时就医。疼痛或肿胀突然加重亦需尽快处理。早期评估有助于管理感染等并发症，其发生率为2.5%。您的外科医生可讨论从保守治疗到手术修复的各种方案，以恢复功能与外观。

Reviewed by AI synthesis (v2) — pending human review · 18 May 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Fingertip injuries in children are common and result in significant burden [1].
  • Most fingertip injuries in children are preventable [1].
  • Most fingertip injuries in children occur at home, often involving a door or window [1].
  • Secondary procedures are often necessary following hand and digit replants [6].
  • Demographics play a significant role in the decision for finger replantation and its outcomes, in addition to injury factors [7].
  • Age alone should not be an absolute contraindication to finger replantation [21].
  • Patient preference is not driving the decrease in finger replantations in the US [32].
  • Surgical indications for distal replantation, nail bed, and nail problems in musicians are often difficult because technical demands may not be familiar to the hand surgeon [11].
  • The expectation of returning to 'normal' is not always possible in severe trauma for musicians with distal replantation, nail bed, or nail problems [11].
  • There is insufficient evidence to determine the best treatment method for composite defects of the fingertips due to the lack of prospective randomized trials and disparate retrospective case series [13].
  • The philosophy of digital replantation aims to ensure not only the survival of a digit but its functional use as well [22].
  • The current data are inadequate to make comments regarding donor site morbidity for toe-to-thumb transfers for isolated traumatic thumb amputation [23].
  • An evidence-based recommendation for the superiority of a specific type of toe-to-thumb transfer cannot be made [23].
  • The low incidence of infection (2.5%) and lack of a meaningful difference between groups call into question prophylactic antibiotic prescribing after distal fingertip amputation and crush injuries [4].

Anatomy & Pathophysiology

  • Demographics play a significant role in the decision for finger replantation and its outcomes [7].
  • Sex, age, and regional differences are observed in partial hand and finger amputations, suggesting disparities in burden [42].
  • Understanding differences in anatomy, physiology, mechanism of injury, surgical technique, and outcomes is crucial for pediatric replantation results [39].

Classification

  • Fingertip injuries in children are common and result in significant burden [1].
  • Most fingertip injuries in children are preventable [1].
  • Most fingertip injuries in children occur at home, specifically involving doors or windows [1].
  • Traumatic finger amputations have a bimodal incidence [20].
  • The epidemiology and mechanism of traumatic finger amputations change with age [20].
  • Patients presenting with abuse are significantly more likely to have fingertip injuries during childhood compared with those without recorded abuse [9].
  • Fingertip injuries in childhood may be indicative of abuse or neglect [9].
  • Secondary procedures are often necessary following hand and digit replants [6].
  • Demographics play a significant role in the decision for finger replantation and its outcomes in pediatric patients, in addition to injury factors [7].
  • The treatment of the mutilated hand is considered the most challenging acute hand injury that hand surgeons treat [10].
  • Surgical indications for distal replantation, nail bed, and nail problems in musicians are often difficult due to technical demands unfamiliar to hand surgeons and unrealistic patient expectations of returning to 'normal' after severe trauma [11].
  • Age significantly influences the survival rate of digital replantation [16].
  • The injured hand significantly influences the survival rate of digital replantation [16].
  • Injury type significantly influences the survival rate of digital replantation [16].
  • The zone of injury significantly influences the survival rate of digital replantation [16].
  • The method of preservation of the amputated digit significantly influences the survival rate of digital replantation [16].
  • Index finger injury is associated with higher odds of symptomatic neuroma following revision amputation for traumatic digital amputation [19].
  • Avulsion mechanism is associated with higher odds of symptomatic neuroma following revision amputation for traumatic digital amputation [19].

Clinical Presentation

  • Traumatic finger amputations have a bimodal incidence with changing epidemiology and mechanism of injury with age [20].
  • Patients presenting with abuse are significantly more likely to have fingertip injuries during childhood compared with those without recorded abuse [9].
  • Fingertip injuries in childhood may be ones of abuse or neglect [9].
  • The amputations of the distal phalanx and the thumb seem to have a somewhat worse prognosis for digit replantation [14].
  • Male sex seems to have a somewhat worse prognosis for digit replantation [14].
  • Ischemia time of greater than 12 hours seems to have a somewhat worse prognosis for digit replantation [14].
  • Demographics play a significant role in the decision for finger replantation and its outcomes in pediatric patients [7].
  • Digital amputation is common in the setting of diabetic finger infection [31].
  • Hand surgeons should consider prognostic implications when counseling patients regarding mortality and revision following digital amputation for infection and necrosis [18].
  • Index finger injury is associated with higher odds of symptomatic neuroma following revision amputation for traumatic digital amputation [19].
  • Avulsion mechanism is associated with higher odds of symptomatic neuroma following revision amputation for traumatic digital amputation [19].

Investigations

  • Fingertip injuries in children are common and result in a significant burden [1].
  • Most fingertip injuries in children occur at home, specifically involving doors or windows [1].
  • Fingertip injuries in the context of abuse may indicate abuse or neglect [9].
  • Complications of distal phalanx fractures in children are frequent [44].

Treatment

General Management Principles

  • Proper management of fingertip injuries focuses on robust soft-tissue coverage, maximizing functional length, and preserving nail function to achieve good outcomes [5].
  • The precise management of fingertip injuries in adults depends on the degree of injury, with various operative and non-operative techniques available for successful employment [8].
  • Conservative treatment with semiocclusive dressings is increasingly acceptable for fingertip and thumb tip injuries due to excellent results in restoring contour, sensibility, and aesthetics [34].

Antibiotic Prophylaxis

  • Prophylactic antibiotic prescribing after distal fingertip amputation and crush injury is questionable due to a low infection incidence (2.5%) and lack of meaningful difference between groups [4].

Operative Reconstruction Techniques

  • The parallelogram flap is considered a better choice than the homodigital island flap for reconstruction of fingertip defects with bone exposure [2].
  • Application of artificial dermis combined with a medial flap from the second toe restores fingernail appearance and preserves finger length and function without damaging the toenail in degloving injuries [3].
  • Specific techniques can be incorporated to improve efficiency and success in digit replantation [24].

Digital Replantation and Revascularization

  • The decision to replant, revascularize, or amputate a nonviable digit is related to injury factors (mechanism, affected digit, zone of injury) and the surgeon [38].
  • Factors significantly influencing the survival rate of digital replantation include age, injured hand, injury type, zone, and the method of preservation of the amputated digit [16].
  • The need for a vein graft for a large zone of injury should not be considered a relative contraindication to perform revascularization or replantation of dysvascular digits [30].
  • Both functional outcomes and patient-reported outcomes facilitate a comprehensive assessment of the benefits of replantation for amputation injuries in the hand [15].
  • Treatment of the mutilated hand is considered one of the most challenging acute hand injuries for hand surgeons [10].

Toe-to-Thumb Transfers

  • Current data are inadequate to make comments regarding donor site morbidity for toe-to-thumb transfers [23].

Complications

  • Secondary procedures are often necessary following hand and digit replantation [6].
  • Infections can mimic common conditions in the fingertip, requiring awareness of obscure conditions and relevant anatomy [12].
  • Amputations of the distal phalanx have a somewhat worse prognosis [14].
  • Amputations of the thumb have a somewhat worse prognosis [14].
  • Male gender is associated with a somewhat worse prognosis for digit replantation [14].
  • Ischemia time greater than 12 hours is associated with a somewhat worse prognosis for digit replantation [14].
  • Traumatic finger amputations have a bimodal incidence [20].
  • The epidemiology and mechanism of injury for traumatic finger amputations change with age [20].
  • Delaying replantation of digits overnight yields survival outcomes comparable to immediate replantation in selected cases [26].
  • There is no significant difference in the incidence of unplanned or secondary revision of fingertip amputation after initial procedure performed in the ED versus the OR [35].

Recovery

  • Incorporating specific techniques improves efficiency and success in digit replantation [24].
  • For simple nailbed injuries, patients have consistently good early outcomes irrespective of the intervention [25].
  • Most patients with fingertip injuries can achieve good outcomes with proper management focusing on robust soft-tissue coverage, maximizing functional length, and preserving nail function [5].

Key Evidence

  • [L4] Fingertip injuries in children are common and result in significant burden, yet are mostly preventable, with most injuries occurring at home in a door or window. [1] (10.1177/1558944716670139)
  • [L2] This method is a better choice for reconstruction of fingertip injury. [2] (10.1186/s13018-022-03214-1)
  • [L4] The surgical technique restores the appearance of the injured fingernail and preserves the length and function of the injured finger without damaging the toenail. [3] (10.1016/j.jhsa.2023.12.003)
  • [L3] The low incidence of infection (2.5%) and lack of a meaningful difference between groups call into question prophylactic antibiotic prescribing after these distal fingertip injuries. [4] (10.1016/j.jhsg.2023.07.010)
  • [L5] With proper management focusing on robust soft-tissue coverage, maximizing functional length, and preserving nail function, most patients with fingertip injuries can achieve good outcomes. [5] (10.5435/jaaos-d-24-00818)
  • [Paper] Secondary procedures are often necessary following hand and digit replants. [6] (10.1055/s-0039-1681981)
  • [L3] Our findings demonstrate that in addition to injury factors, demographics play a significant role in the decision for finger replantation and its outcomes. [7] (10.1177/1558944719873150)
  • [Paper] However, the precise management of a fingertip injury in adults depends on the degree of injury itself, and a number of operative and non-operative techniques may be successfully employed. [8] (10.1016/j.injury.2017.10.042)
  • [L3] Patients presenting with abuse are significantly more likely to have fingertip injuries during childhood compared with those without recorded abuse, which suggests that these injuries may be ones of abuse or neglect. [9] (10.1016/j.jhsg.2019.09.001)
  • [L5] The treatment of the mutilated hand is perhaps the most challenging acute hand injury that hand surgeons treat. [10] (10.1016/s0749-0712(02)00137-3)
  • [L5] Surgical indications are often difficult because their technical demands may not be familiar to the hand surgeon and their expectation of returning to 'normal' is not always possible in severe trauma. [11] (10.1016/s0749-0712(02)00135-x)
  • [Paper] This review seeks to direct clinicians in an evidence-based manner, to make them aware of more obscure conditions that can mimic common infections, and to provide an understanding of the relevant anatomy of the fingertip. [12] (10.1016/j.hcl.2020.03.004)
  • [L5] There is insufficient evidence to determine the best treatment method for composite defects of the fingertips due to the lack of prospective randomized trials and disparate retrospective case series. [13] (10.1016/j.jhsa.2008.07.001)
  • [L1] The amputations of the distal phalanx and the thumb, being male, and ischemia time of greater than 12 hours seem to have a somewhat worse prognosis. [14] (10.1097/01.bth.0000225005.64605.17)
  • [L4] Both functional outcomes and patient-reported outcomes together facilitate a comprehensive assessment of the benefits of replantation for amputation injuries in the hand. [15] (10.1016/j.hcl.2018.12.008)
  • [L5] Age, injured hand, injury type, zone, and the method of preservation the amputated digit significantly influence the survival rate of digital replantation. [16] (10.1177/1753193415594572)
  • [L4] Hand surgeons should consider the prognostic implications of these data when counseling patients. [18] (10.1016/j.jhsa.2023.01.014)
  • [L4] Index finger injury and avulsion mechanism were associated with higher odds of symptomatic neuroma. [19] (10.1016/j.jhsa.2017.06.070)
  • [L4] Traumatic finger amputations have a bimodal incidence with changing epidemiology and mechanism of injury with age. [20] (10.1177/15589447221122826)
  • [L3] Age alone should not be an absolute contraindication to finger replantation. [21] (10.1016/j.jhsa.2011.01.031)
  • [L5] The most significant guideline underlining the philosophy of digital replantation today reflects the aim of not only ensuring the survival of a digit, but its functional use as well. [22] (10.1054/jhsb.2001.0595)
  • [L2] The current data are inadequate to make any comments with regards to donor site morbidity, and an evidence-based recommendation for the superiority of a specific type of toe-to-thumb transfer cannot be made. [23] (10.1007/s11552-011-9340-x)
  • [L5] Incorporating specific techniques improves efficiency and success in digit replantation. [24] (10.1016/j.jhsg.2024.07.010)
  • [L4] For simple nailbed injuries, patients had consistently good early outcomes irrespective of the intervention. [25] (10.1016/j.jhsg.2025.100880)
  • [L4] The results of delaying replantation of digits overnight give results comparable with those of immediate replantation in selected cases. [26] (10.1016/j.jhsa.2018.03.047)
  • [L3] The need for a vein graft for a large zone of injury should not be considered a relative contraindication to perform revascularization or replantation of dysvascular digits. [30] (10.1016/j.jhsa.2017.06.080)
  • [L3] Digital amputation is common in the setting of diabetic finger infection. [31] (10.1177/15589447221082160)
  • [L3] Patient preference is not driving the decrease in finger replantations in the US. [32] (10.1016/j.jhsa.2015.05.026)
  • [L5] The article provides an update on the most commonly used flaps and semiocclusive dressing treatments for fingertip and thumb tip injuries, noting that conservative treatment with semiocclusive dressings has become more acceptable due to excellent results in restoring contour, sensibility, and aesthetics. [34] (10.1016/j.jhsa.2017.01.022)
  • [L3] There is no significant difference in the incidence of unplanned/secondary revision of fingertip amputation rate after the initial procedure was performed in the ED versus the OR. [35] (10.1177/1558944718790577)
  • [L3] The decision to replant, revascularize, or amputate a nonviable digit and the success of replantation and revascularization are related to both injury factors, such as mechanism of injury, affected digit, and zone of injury, and the surgeon. [38] (10.1007/s11552-013-9520-y)
  • [L4] Understanding the various differences in anatomy, physiology, mechanism of injury, surgical technique, and outcomes is crucial to obtaining the best possible result for the child and family. [39] (10.1016/j.jhsa.2013.09.002)
  • [L3] Sex, age, and regional differences were observed, suggesting the need for targeted interventions to address disparities and mitigate the burden of finger and partial hand amputations on affected individuals. [42] (10.1186/s12891-024-07939-4)
  • [L4] Complications of distal phalanx fractures in children are frequent. [44] (10.1016/j.jhsa.2017.03.042)

References

[1] Fingertip Injuries in Children: Epidemiology, Financial Burden, and Implications for Prevention. HAND. 2016. DOI: 10.1177/1558944716670139

[2] Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study. Journal of Orthopaedic Surgery and Research. 2022. DOI: 10.1186/s13018-022-03214-1

[3] Application of Artificial Dermis Combined With a Medial Flap From the Second Toe to Repair Degloving Injury of the Fingertip. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.12.003

[4] Antibiotic Prophylaxis in the Management of Distal Fingertip Amputation and Crush Injury. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2023.07.010

[5] Fingertip Injuries: A Review and Update on Management. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-24-00818

[6] Characteristics of Secondary Procedures following Digit and Hand Replantation. Journal of Hand and Microsurgery. 2019. DOI: 10.1055/s-0039-1681981

[7] Pediatric Digit Replantation Following Traumatic Amputation: Nationwide Analysis of Patient Selection, Outcomes, and Cost. HAND. 2019. DOI: 10.1177/1558944719873150

[8] Management of partial fingertip amputation in adults: Operative and non operative treatment. Injury. 2017. DOI: 10.1016/j.injury.2017.10.042

[9] Pediatric Fingertip Injuries: Association With Child Abuse. Journal of Hand Surgery Global Online. 2020. DOI: 10.1016/j.jhsg.2019.09.001

[10] Replantation in the mutilated hand. Hand Clinics. 2003. DOI: 10.1016/s0749-0712(02)00137-3

[11] Distal replantation, nail bed, and nail problems in musicians. Hand Clinics. 2003. DOI: 10.1016/s0749-0712(02)00135-x

[12] Fingertip Infections. Hand Clinics. 2020. DOI: 10.1016/j.hcl.2020.03.004

[13] Fingertip Reconstruction. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2008.07.001

[14] A Meta-analysis of Success Rates for Digit Replantation. Techniques in Hand & Upper Extremity Surgery. 2006. DOI: 10.1097/01.bth.0000225005.64605.17

[15] Outcomes Following Replantation/Revascularization in the Hand. Hand Clinics. 2019. DOI: 10.1016/j.hcl.2018.12.008

[16] Effects of non-surgical factors on digital replantation survival rate: a meta-analysis. Journal of Hand Surgery (European Volume). 2015. DOI: 10.1177/1753193415594572

[18] Predictors of Mortality and Revision Following Digital Amputation for Infection and Necrosis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.01.014

[19] Symptomatic Neuroma following Revision Amputation for Traumatic Digital Amputation. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.070

[20] Traumatic Finger Amputations: Epidemiology and Mechanism of Injury, 2010-2019. HAND. 2022. DOI: 10.1177/15589447221122826

[21] Adverse Events Following Digital Replantation in the Elderly. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.01.031

[22] Indications and Selection for Digital Amputation and Replantation. Journal of Hand Surgery. 2001. DOI: 10.1054/jhsb.2001.0595

[23] A Systematic Review of Outcomes of Toe-to-Thumb Transfers for Isolated Traumatic Thumb Amputation. HAND. 2011. DOI: 10.1007/s11552-011-9340-x

[24] Efficient Replantation: Techniques, Tricks, and Secondary Procedures for Improved Functional Outcomes. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2024.07.010

[25] Reevaluating Pediatric Nailbed Injuries: Are We Overtreating Simple Cases?. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2025.100880

[26] Immediate Versus Overnight-Delayed Digital Replantation: Comparative Retrospective Cohort Study of Survival Outcomes. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2018.03.047

[30] Survival Rate of Revascularization and Replantation of Digits with Vein Graft Versus Direct Arterial Anastomosis. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.080

[31] Predictors of Digital Amputation in Diabetic Patients With Surgically Treated Finger Infections. HAND. 2022. DOI: 10.1177/15589447221082160

[32] A Comparative Study of Attitudes Regarding Digit Replantation in the United States and Japan. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.05.026

[34] Fingertip and Thumb Tip Wounds: Changing Algorithms for Sensation, Aesthetics, and Function. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.01.022

[35] Cost-Effectiveness of Initial Revision Digit Amputation Performed in the Emergency Department Versus the Operating Room. HAND. 2018. DOI: 10.1177/1558944718790577

[38] Replantation and Revascularization vs. Amputation in Injured Digits. HAND. 2013. DOI: 10.1007/s11552-013-9520-y

[39] Pediatric Replantation. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2013.09.002

[42] Partial hand and finger amputations in Sweden: an observational study of 6918 patients. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07939-4

[44] Complications of Distal Phalanx Fractures in Children. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.03.042

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