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TRAUMATIC FINGER AMPUTATIONS
The hand is one of our organs that has developed man throughout history, fought and even enabled him to do subtle things that are invisible to the eye today, and our main organ is the brain, where a large part is reserved for its function, literally making man human.No matter how necessary it is for a person to keep an eye on the nose and mouth, in order to fully taste the life that will be lived with the soundness of these, hands, especially fingers, are indispensable if we do not have them.
Although today technology is increasing, medical techniques are developing, people are blinking, but people can still lose their limbs as a result of many careless events.
Whether the fingers will be saved, the type of injury, the level, the time taken to get to the health center, the patient’s age, smoking … for example, it depends on many factors, and the type of injury that we can say that it will be 100% saved in the literature cannot be defined for this reason.
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ANATOMY
First of all, I would like to briefly talk about the anatomy of the fingers: the fingers consist of 3 parts, except for the thumb, and these parts are connected to each other by structures that are the main element in the formation of movement, which we call joints (hinge in common parlance).Each finger has an artery that feeds itself and extends from both sides to the fingertip, and this artery is accompanied by a nerve and a vein of balls in its neighborhood.The thinness of these arteries increases as they move to the fingertip, and when they reach the nail level, they no longer become invisible.
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TYPE OF INJURY
Although the types of injuries vary a lot, spiral, axe, glass, crush-style injuries are mostly encountered in the area where I am located.The more intense the force the finger encounters, the more it will be damaged and the chance of holding it will decrease by a lot.As physicians, the types of accidents that make us hopeful are the types of accidents that we call knife, axe, gyotin incision, where the finger is not exposed to a lot of force, only the parts where the cutting tool touches are damaged.Don’t get crushed, don’t get stuck somewhere, in breaks caused by cutting with a motor, the finger is exposed to injury not only at the incision site that caused its rupture, but also in other areas that appear intact, and since the vein that needs to be sutured is mostly exposed to cracking in these invisible places, the chances of recovery are not very high even if microsurgically repaired. Since the vascular structures other than the incision are intact in the knife incisions, which we call a smooth incision, the finger is mostly saved with a successful microsurgical technique.
Level:
The further the finger is severed from the back, the thicker the vein that needs to be sewn, the greater the chance of success of the vein repair result. On the contrary, since the vessel thickness will decrease gradually in the extreme parts, the success results of surgeries in these parts will be so much lower. Especially in breaks further from the end joint (Bottom joint), the chance of success is therefore lower. However, what we call a “composite” treatment method, especially as the age decreases and the rupture approaches the end part, the chances of success increase, techniques in which only the severed part is sutured instead of vascular repair are used only in the end regions, and the chances of success in ruptures close to the end part are so high in this technique.
Age:
Since blockage and narrowing of the vessels begin at an advanced age, the chance of microsurgery decreases so much, on the contrary, for injuries that occur at a very young age, the surgical experience must be more for success.
Cigarette:
Surgical success rates are lower in those who use cigarettes and other tobacco products, diabetics, patients with high cholesterol, as vascular blockages and especially constrictions occur.
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COMPLEX INJURIES
In types of injuries where bone tissue is shattered, especially the joint areas that we call hinges are damaged, even if the finger is saved after surgery, the joint injury cannot be repaired, there is a loss of function in the fingers, and the treatment processes are very prolonged.
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GENERAL PROCEDURE
A person with a finger injury should first of all not panic and try to find the severed part if its integrity is intact, wrap it with a cloth and put it in a bag, then put this bag in another bag full of ice water and contact the nearest medical institution in this way.It is necessary to pay attention to the prevention of freezing of the part by direct contact with ice. If there is a lot of bleeding in the part where the finger is severed, the finger can be tightly tied with a rubber or a rope from the back of the severed place (tourniquet) and kept in this way for 2 hours without opening.
As book information, the chances of success in complete breaks are high within the first 6 hours, and the broken part should be stored properly during this time.A person who has a severed finger should consider the possibility of surgery and stop eating and drinking to reduce time loss, remember that 6 hours of fasting is required to undergo surgery, otherwise food in the stomach during surgery can escape into the windpipe and lead to vital loss.
If the finger is holding a part that is not completely severed:
1- One of the two veins may be intact, which means that the probability of losing a finger will be very low, because a bumar is enough for a finger.
2- It may be clinging to the skin, in which case the finger should be brought to its normal position by placing a cardboard , thin board or abs used to look at the throat in medical institutions under the finger, and the patient should be dressed in this way and delivered to the medical institution where the operation will be performed. Dressing in this way will prevent the impaired circulation of the finger from getting worse and will lead to an increased chance of retention.
3- The chances of retention are low in types of injuries where the bone structure is broken down.
4- The chances of retention in graze-style, crush-style injuries are very low.
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DURING THE OPERATION
– The operation can usually be performed under general anesthesia or in cases where it is desired to prevent axillary block or loss of time, which we call digital block, only the finger is numbed.
– After the operation, the hand and forearm are placed in a resting half splint, and if there is a bone and tendon injury, this splint can remain for up to 6 weeks.
– The duration of hospitalization usually reaches 1 week, and during this time, treatments that increase the chance of finger retention are given to the patient.
– It becomes clear within the first 1 week whether the finger will hold, but in rare cases, although success is achieved in the first 1 week, the finger may be lost as a result of injuries received to the operation area after discharge.
In short:
1- Find the broken part and store it properly
2- Do not eat or drink anything and contact the nearest medical institution
3- If you are bleeding, make a tourniquet
4- Stay away from bloodletting-reducing substances at extreme points, such as cigarettes, after an accident.
Op. Dr.
Antalya MedicalPark Hospital Plastic, Reconstructive and Aesthetic Surgeon
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Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.
Physician's Resume:
Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.
Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.
In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.
Awards:
Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.
Certificates:
Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .
Professional Members:
American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.
Disclaimer:
Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.