Abstract: Background: Injuries to the dorsal elements of the fingertip arise both out of occupational and non-occupational causes leading to considerable morbidity. The increasing use of mechanized tools both at home and work has also contributed to an increase in such injuries. The management of such injuries involves protecting the nail bed, achieving effective wound healing and return to pre-injury employment.
Methods: Fifty-eight patients were included in this study. All the patients were managed on out-patient basis with tension band suturing (TBS). Instead of a K-wire, an 18G needle was used. Patients requiring general anesthesia, loss of nail, with amputations of the volar pulp and associated injuries of the same limb were excluded from the study. Epidemiological data such as type of injury (occupational or non-occupational), demand type (high-demand type or low-demand type) and time taken to achieve pre-injury employment was collected.
Results: The average time to suture and implant removal was between three to four weeks. Two patients required early removal due to infection. All patients resumed their pre-injury occupation. Epidemiological results can be enumerated as follows. 1.Mean age – 31.74 years 2.Occupational injury vs. Non-occupational injury (36 vs. 22) 3.High demand type vs. Low demand type (38 vs. 20) and 4.Time off work in High demand type vs. Low demand type (38.21 days vs. 33.35 days).
Conclusion: The technique of tension band suturing is an efficient outpatient treatment method. The use of an 18 G needle instead of a K-wire provides good results, avoids the need of mechanized drills and provided a suitable alternative in centers with limited resources. The time off work depends on the patient’s occupation and ranges from 33.35 days to 38.21 days. All patients returned to their pre-injury employment.
