20250708 Fingertip injuries - Dr Thivagar

A 4 year-old boy sustained an avulsion nailbed injury of the middle finger  when he fell from bicycle. Clinical photo and radiograph are as shown. What is the best next step of management ?

• A. Irrigation, debridement and splinting

• B. Irrigation, debridement, reduction & K-wire, nailbed repair and immobilization

• C. Irrigation, K-wiring of index finger

• D. Irrigation, debridement , nailbed repair, immobilization

A 22 year old man alleged hit his finger by a hammer at work. Post trauma, complained of pain at tip of right middle finger. Radiograph showed no fracture of distal phalanx. Clinical presentation is shown as below.

What is the best treatment for this patient?

• A. For observation

• B. Nail plate removal and irrigation

• C. Nail plate removal, irrigation and replace native nail

• D. For Trephination of hematoma

A 8 year-old boy sustained an amputation at he middle finger while shutting a door. He was brought to ED with the amputated tip in a ice bag. Clinical presentation as in the picture with bone exposed. Which of the following is the best course of management

• A. Irrigation, revision at DIPJ

• B. Irrigation, debridement and occlusive dressing

• C. Irrigation, nail bed repair and replantation of finger tip

• D. Irrigation, debridement , V-Y plasty

What is the complication that is most likely to occur in the following procedure ?

• A. Contracture of the IPJ

• B. Flap failure

• C. Median nerve motor branch injury

• D. Mismatch of the skin

A 30 year-male sustained a volar oblique finger tip injury at his right little finger with no bone exposed. Which of the following surgical procedure would best cover this injury?

• A. V-Y plasty

• B. Thenar flap

• C. Cross finger flap

• D. Reverse cross finger flap