A Threshold QuickDASH Score for Estimating a Diagnosis of Major Depression in Patients With Fingertip Injuries in the American and Dutch Population

Background: The aim was to determine the threshold Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score that estimates a diagnosis of major depression in patients with fingertip injuries in American and Dutch patients. Methods: In this observational cross-sectional study, 112 patients with a recent fingertip injury measured symptoms of depression with the Patient Health Questionnaire and upper extremity disability with the QuickDASH. Results: In the US cohort, 8 of 56 patients had an estimated diagnosis of major depression. A threshold value of QuickDASH of 50 showed a sensitivity of 88% and a specificity of 81%, with a negative predicting value (NPV) of 95% for an estimated diagnosis of major depression. In the Dutch cohort, 7 of 56 patients had an estimated diagnosis of major depression. The same threshold score of 50 had a sensitivity of 71%, a specificity of 63%, and an NPV of 94%. Conclusions: We have found a correlation between experienced loss of function and an estimated diagnosis of major depression in patients with a fingertip injury. Referral to the primary care physician for further evaluation of depression in these patients is advised.

Infected Epidermoid Cyst Including Multiple Nails at the Amputated Thumb Stump: A Case Report

Fingertip amputation is a common injury among trauma occurring in the upper extremity. After amputation of the fingertip, there are several treatment options according to the degree of damage. Also, the skin flap is sometimes performed when skin defects are accompanied. Among the complications associated with fingertip injury, cyst formation at the amputation stump is rare but some cases have been reported based on the pathologic findings. There was a case of an infected epidermal inclusion cyst containing multiple nail plates at the amputation stump of the thumb, so we would like to report it with a review of the literature.

Simultaneous Volar Pulp and Nail Bed Reconstruction with the Second Toe Onychocutaneous Free Flap

Fingertip injury is one of the most common hand injuries. Although several types of advancement and cross-finger flaps exist, they would not be essential for nail bed defects. The authors present a simultaneous volar pulp and nail bed reconstructive technique that uses a second toe onychocutaneous free flap. Four patients without amputees underwent fingertip amputation reconstruction between 2011 and 2019. After thorough debridement, the defect size was estimated, and the digital arteries, nerves, and veins of the recipient were evaluated. The flap, composed of pulp tissue and nail bed, was harvested with continuity from the second toe. Additional split-thickness skin grafts were performed in two cases. All flaps survived without considerable complications. We evaluated the scar and contour, and nail growth was reported over Zook’s criteria grade B. The second toe onychocutaneous free flap provides a reliable option for fingertip defects that involve pulp tissue and nail bed without further amputation.

V-Y Plasty in the Treatment of Fingertip Injuries

Background: Hand is a highly specialized organ as it has grasping, pinching and hooking function. The hand is prone to domestic and industrial trauma with fingertips being the most frequently injured portion of the hand. Fingertip injuries are commonly seen by emergency physicians Objectives: To see the functional outcome after V-Y flap in fingertip injuries. Methods: Prospective, observational study carried out for 2 years at National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR). Fifteen patients of fingertip injuries were selected for V-Y flap. Results: V-Y plasty was performed in 15 patients who suffered from a transverse amputation of the finger tip. Out of 15 patients, functional outcome was satisfactory (good) in 13(86.7%) cases and unsatisfactory (fair plus poor) in 2 cases (13.3%). 3 patients had postoperative complications. The results showed that V-Y plasty is indicated in transverse amputations through the distal one-third to one-half of the nail bed. Conclusion: Fingertip injury can achieve almost normal sensibility and satisfactory motion by V-Y flap and patients can expect to return to work on average approximately 3 weeks after operation. TAJ 2020; 33(2): 107-112

The use of Dermacell® in Fingertip Injury

Matrices or tissue scaffolds provide a collagen structure for tissue remodelling while the removal of viable cells aims to minimize or prevent inflammatory or immunogenic response. Allograft collagen scaffold can support the patient’s own cellular ingrowth, ingeneered to minimize an immune response and to yeld a bio-compatible matrix and support incoming cellular growth. The decellyularized dermis retains its growth factors, native collagen scaffold, and elastin, thanks to a LifeNet Health proprietaryprocessin technology.