Conservative treatment of traumatic finger amputations using negative-pressure wound therapy.

Replantation is widely regarded as the first choice of treatment for finger amputations. However, if the fingertip of a traumatic finger amputation is missing after an injury, the following procedures are often performed to reconstruct this portion: flap surgery, stump surgery, or conservative treatment, including occlusive dressings. To our knowledge, no existing English literature reports using negative-pressure wound therapy (NPWT) to treat traumatic finger amputations. We postulated that NPWT may be applied as a conservative treatment for traumatic finger amputations, promoting the growth of granulation tissue and achieving early epithelialization of the fingertips. Among the case series of five patients, we included six injured fingers comprising two index, two middle, and two ring fingers. The fingertip of each traumatic finger amputation was either missing or highly crushed, making replantation impossible. To preserve finger length with conservative treatment, we adapted an NPWT device for finger amputations. It took an average of 22.7 days for the fingertips to epithelialize. Immediately after epithelialization, there was a slight decrease in sensory perception; however, all patients showed good recovery of sensory perception after 3 months. Range of motion remained unrestricted, with no reduction in grip strength. Patients were highly satisfied with their fingertip appearance. The regenerated nail exhibited slight deformation and shortening. No complications were observed. Our novel study regarding this new conservative treatment and its outcomes revealed that healing was achieved in a relatively short period; therefore, NPWT may serve as a new conservative treatment option in the future.

Magnetic Resonance Imaging Evaluation of Acute Plastic Deformation of a Pediatric Radius.

Acute plastic deformation of long bones is more common in young children. We report a case of an acute plastic deformation of a pediatric radius via magnetic resonance imaging (MRI) evaluation. A 15-year-old boy fell on landing after a jump while practicing soccer, which injured his right forearm. He was diagnosed with a radial neck fracture and a medial epicondylar fracture of the humerus on the basis of plain radiograms. MRI was additionally performed and showed abnormal shadows indicating intramedullary bleeding at multiple bamboo-joint-like deformity sites of the radius. Surgery was performed and injury completely healed. Acute plastic deformation of long bones was often diagnosed by simple radiographic imaging. To our knowledge, there has been no previous reports of plastic deformation evaluated by MRI. If bone plastic deformation is missed, functional impairments such as limited range of motion remain; thus, an early diagnosis of acute bone plastic deformation by performing MRI is recommended.