Polypropylene prosthesis for the treatment of fingertip injuries. Description of surgical technique and results☆

Figueiredo, Leandro Azevedo de; Ribeiro, Rafael de Souza; Melo, Antonio Leão Bandeira de; Lima, André Luiz; Terra, Bernardo Barcellos; Ventim, Fernando Carvalho

doi:10.1016/j.rboe.2016.10.017

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ORIGINAL ARTICLE • Rev. bras. ortop. 52 (06) • Nov-Dec 2017 • https://doi.org/10.1016/j.rboe.2016.10.017 copy

Polypropylene prosthesis for the treatment of fingertip injuries. Description of surgical technique and results^☆ ☆ Study conducted at the Santa Casa de Misericórdia de Vitória, Departamento de Ortopedia e Traumatologia, Vitória, ES, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

Report the results of treatment of fingertip injuries and describe this reproducible and low cost surgical technique, which utilizes a polypropylene prosthesis that temporarily replaces the nail and is placed on the area of injury, providing protection and encouragement for healing by secondary intention.

METHOD:

This study evaluated 22 patients with traumatic injuries of the fingertips in the period from January 2012 to December 2015. All procedures were performed by the same surgeon. The mean postoperative follow-up was 13 months, with a minimum follow-up of six months. For all statistical inferences, a p-value of 0.05 was considered. The software used was SPSS version 21.0 for Windows.

RESULTS:

There were no cases of complications related to the polypropylene device. There was no significant difference between static two-point discrimination and age, between discrimination and time between injury and surgery, or between discrimination and time to follow-up. The authors used a table of scores that includes three factors proposed by Jefferson for a better evaluation of the results. 72.7% (16 cases) of patients had good results, 22.7% (five cases) fair results, and only 4.5% (one case) poor result.

CONCLUSION:

This study presented a new technique for finger tip lesions, simple and easily reproducible, with satisfactory results and low complication rates.

Keywords:
Finger phalanges; Fingers injuries; Adults

	N	Mean	SD	Median	Min	Max
Age (years)	22	40.27	14.7	39	16	67
2PD (mm)	22	2.86	0.68	3	2	4
Time from injury to surgery (days)	22	5.38	7.17	2	0.5	28
Follow-up (months)	22	13.05	7.14	12	6	36

	Frequency (n)	%
Gender
Male	20	90.9
Female	2	9.1

Side
Right	9	40.9
Left	13	59.1

Finger
Ring	5	22.7
Index	6	27.3
Middle	6	27.3
Little	2	9.1
Thumb	3	13.6

Cause
Car accident	1	4.5
Crushing	10	45.5
Explosion	1	4.5
Power drill	1	4.5
Polishing machine	1	4.5
Saw	3	13.6
Firearm projectile	1	4.5
Direct trauma	2	9.1
Chain trauma	1	4.5
Door trauma	1	4.5

Infection
Yes	2	9.1
No	20	90.9

2PD
Normal	17	77.3
Satisfactory	5	22.7

Neuroma
No	21	95.5
Yes	1	4.5

Growth
1	2	9.1
2	20	90.9

Size
0	2	9.1
1	3	13.6
2	17	77.3

Shape
0	2	9.1
1	12	54.5
2	8	36.4

Subjective evaluation
Good	12	54.5
Excellent	10	45.5

	Score				p-Value
	≤3	4	5	6
	M (± SD)	M (± SD)	M (± SD)	M (± SD)
Age (years)	58.5 (± 9.19)	28.5 (± 3.82)	40.2 (± 14.0)	41.8 (± 14.2)	0.1
Time from injury to surgery (days)	10.7 (± 14.42)	3.5 (± 3.71)	6.0 (± 9.00)	4.0 (± 3.78)	0.97
Follow-up (months)	6.5 (± 0.7)	19.4 (± 11.3)	12.4 (± 5.51)	12.0 (± 5.38)	0.16

	Evaluation	Subjective	p-Value
	Good	Excellent
	M (± SD)	M (± SD)
Age (years)	44.8 (± 13.4)	34.4 (± 13.4)	0.09
Time from injury to surgery (days)	4.2 (± 7.6)	6.7 (± 6.6)	0.22
Follow-up (months)	13.4 (± 5.5)	12.6 (± 9.0)	0.49

	Sensitivity		p-Value
	Normal	Satisfactory
	M (± SD)	M (± SD)
Age (years)	41.88 (± 13.4)	34.81 (± 16.3)	0.35
Time from injury to surgery (days)	6.35 (± 9.92)	2.00 (± 1.0)	0.64
Follow-up (months)	12.24 (± 7.7)	15.8 (± 3.4)	0.12

	r	p-Value
2PD vs. age	0.23	0.98
2PD vs. time between injury and surgery	-0.006	0.3
2PD vs. follow-up time	0.21	0.32

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: bernardomed@hotmail.com (B.B. Terra).

Nail growth	0 = no growth; 1 = partial growth with arrest; 2 = normal growth
Nail size	0 ≤ 50%; 1 = between 50% and 75%; 2 = 75% of the size of the nail on the opposite side
Nail shape	0 = significant deformity in the vertical plane; 1 = small deformity in the vertical plane; 2 = no deformity
Total score 6	The results were obtained by additing up, and the scores were classified as good (5–6), regular (3–4), or poor (<3)

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Polypropylene prosthesis for the treatment of fingertip injuries. Description of surgical technique and results☆ ☆ Study conducted at the Santa Casa de Misericórdia de Vitória, Departamento de Ortopedia e Traumatologia, Vitória, ES, Brazil.

ABSTRACT

OBJECTIVE:

METHOD:

RESULTS:

CONCLUSION:

Polypropylene prosthesis for the treatment of fingertip injuries. Description of surgical technique and results^☆ ☆ Study conducted at the Santa Casa de Misericórdia de Vitória, Departamento de Ortopedia e Traumatologia, Vitória, ES, Brazil.