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J Trauma Acute Care Surg ; 72(6): 1681-7, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22695441

RESUMO

BACKGROUND: In this retrospective study, we analyzed the outcomes of different types of treatment of fingertip injuries and compared them after a mean follow-up of 4.5 years. METHODS: A total of 53 patients (59 injuries) were included in this study. The fingertip injuries were classified according to Allen classification. The patients were categorized into three groups based on the treatment: reconstructive group, bone-shortening group, and conservative group. As objective assessments, strength, sensibility, and goniometry were measured; as subjective assessments, cold intolerance, nail deformation, and aesthetics were measured. RESULTS: The mean reduction in strength, the Semmes-Weinstein monofilament test, and the reduction in mobility for the injured fingers compared with those of the uninjured finger were not significantly different between the groups. Cold intolerance was reported in 50 (84.7%) of the 59 fingers, and in almost 90% of all the cases, there was some kind of nail distortion. For the cold intolerance and nail distortions, there was no difference between the groups. The aesthetic outcomes judged by patients and surgeon were comparable. CONCLUSION: In conclusion, the outcome of treatment of Allen II, III, and IV fingertip injuries was irrespective of the treatment chosen. In an era where the enormous variety of surgical options suggests that treatment with a flap is the best, this outcome is at least surprising. LEVEL OF EVIDENCE: Therapeutic study, level IV.


Assuntos
Traumatismos dos Dedos/diagnóstico , Traumatismos dos Dedos/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Adulto , Idoso , Amputação Traumática/diagnóstico por imagem , Amputação Traumática/cirurgia , Análise de Variância , Alongamento Ósseo/métodos , Estudos de Coortes , Feminino , Seguimentos , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Unhas Malformadas/prevenção & controle , Radiografia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Lesões dos Tecidos Moles/diagnóstico por imagem , Lesões dos Tecidos Moles/cirurgia , Resultado do Tratamento , Cicatrização/fisiologia
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