Circulation:

• The finger is well perfused, pink, turgor, good inflow and no congestion

• Can be assessed by pricking the finger tip with needle if you are concerned with circulation BUT avoid needles that may injury the digital arteries

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Neurological:

• Asses neurovascular bundles - check sensation on both side of the finger

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Wound:

• The skin severely traumatised

• Good pictures of the finger (dorsal and volar) before dressing are useful for the ULQ surgeon

• Use non-stick dressing such has mepitel

• Immobilise in a resting plaster

 

Fracture:

• Assess boney injury with plain x-rays and potentially CT scan if time permits. This helps with operative planning.

• This patient had a highly comminuted proximal phalanx fracture

 

Patient expectation:

• Reconstruction vs Amputation - let this discussion happen between the surgeon and patient to ensure patient expectation will be met