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首页> 外文期刊>Injury >Management of partial fingertip amputation in adults: Operative and non operative treatment
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Management of partial fingertip amputation in adults: Operative and non operative treatment

机译：成人部分指尖截肢的管理：手术和非手术治疗

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Abstract Background Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries that present with varying degrees of contamination. The severity of damage to soft tissue, bone, arteries and nerves is dependent upon the mechanism and guides treatment decision-making. The management algorithm can oftentimes be complex, as a wide variety of providers, including orthopedists, general surgeons, plastic surgeons and emergency physicians, may care for these injuries, depending on location and local culture. We review the common mechanisms for tip amputation and the optimal treatment in adults, based on the severity of the injury, degree of wound contamination, and the facilities available to the provider. Methods Pubmed was searched using text words for articles related to management of fingertip injuries in adults. Bibliographies of matching articles were searched for additional relevant articles, which were then also reviewed. 107 articles were reviewed in total, and 61 were deemed relevant for inclusion. All clinical studies and reviews were included. Particular attention was paid to articles published within the past 15 years. Results In the United States, up to 90% of fingertip amputations are treated with non-replant techniques. In comparison, the majority of amputations in Asian countries are replanted due to moral values and importance of body integrity. Tip amputation injuries can be managed with local debridement, complex reconstruction, or simply with irrigation and application of a sterile dressing. Conclusion In the United States, most fingertip amputations in adults are treated with non-replant techniques. 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.
机译：摘要背景手和手指伤害占每年约480万次访问急诊部门。这些伤害可能对患者和提供者带来大量的痛苦，并且通常最初遇到紧急护理诊所，社区医院和一级创伤中心。尖端截肢伤害的机制差异很大，从锋利的撕裂范围内粉碎损伤，抑制具有不同程度的污染。软组织，骨骼，动脉和神经损伤的严重程度取决于机制和指导治疗决策。管理算法可能是复杂的，因为各种提供商，包括矫形家，普通外科医生，整体外科医生和急诊医生，可能会根据地点和当地文化照顾这些伤害。我们审查了提示截肢的常见机制以及成人的最佳治疗，基于伤害程度，伤口污染程度以及提供者可用的设施。方法使用与成年人指尖伤害有关的文章进行搜查。搜查了匹配物品的书目，以获得其他相关文章，然后还审查。 107条总数审查了61篇，认为有关纳入其中。所有临床研究和评论都包括在内。特别注意过去15年内发表的文章。结果在美国，高达90％的指尖截肢是用非完全技术处理的。相比之下，由于道德价值观和身体诚信的重要性，亚洲国家的大多数截肢都被重新归类。提示截肢伤害可以用局部清创，复杂的重建，或者仅仅用灌溉和应用无菌敷料来管理。结论在美国，大多数成人的指尖截肢都是用非完全技术治疗的。然而，成年人的指尖损伤的精确管理取决于伤害本身的程度，并且可以成功地使用许多操作和不可操作的技术。

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