Digital Tip Amputations from the Perspective of the Nail

The management strategy proposed herein for fingertip amputations advocates secondary healing with preservation of appearanceas well as function. Conservative healing is more likely to result in a sensate, nontender, and cosmetically acceptable fingertipcompared to surgical management in many clinical scenarios. This manuscript examines in detail the extent of fingertip injury anddefines the relationship of injury to final fingertip outcome. A classification is presented, which allows adequate initial counselingregarding prognosis, and predicts the need for secondary corrective surgery.