Clinical Outcomes of Semi-Occlusive Dressing for Allen Type III Fingertip Injuries.

Background/

Objectives

Local flap coverage is still widely regarded as the treatment of choice for Allen type III fingertip injuries, and outcome data for conservative treatment remain limited. We evaluated the outcomes of semi-occlusive dressing for Allen type III fingertip injuries with bone exposure.

Methods

This retrospective single-centre case series included 15 patients with 17 digits sustaining Allen type III fingertip injuries with exposed bone treated with semi-occlusive dressing. Allen type I or II injuries, isolated pulp defects, infection-related tissue loss and incomplete follow-up were excluded. Finger and thumb motion were assessed as total active motion and interphalangeal joint motion, respectively, as a percentage of the contralateral digit. Sensation was assessed using two-point discrimination, Semmes-Weinstein monofilament testing and a subjective contralateral percentage scale.

Results

All 17 digits healed at a mean of 36 days (range 21-60), with a mean follow-up of 25 months (range 12-63). No additional surgery or major complications occurred. Nail deformity developed in four of the 17 digits (24%). Among the 14 fingers, total active motion averaged 95% of the contralateral side (range 80-100) and ten regained full motion; the three thumbs regained mean interphalangeal joint motion of 80% (range 50-100). The mean two-point discrimination was 6 mm, the median Semmes-Weinstein value was 2.83 and the mean subjective sensation was 84%.

Conclusions

In Allen type III fingertip injuries with bone exposure, semi-occlusive dressing achieved reliable healing with satisfactory functional and sensory recovery and may be a useful alternative or adjunct to surgical reconstruction.