The Damaged Index Digit

A SOURCE OF COMPONENTS TO RESTORE THE CRIPPLED HAND

¹ From the Department of Surgery, Palo Alto Stanford Hospital, Palo, Alto

1. When the index finger is irreversibly damaged or amputated, simple removal of the index metacarpal enhances function of the hand by elimination of an obstruction in the web space between the thumb and long finger.

2. Before ray amputation of the index finger is performed, it should be inventoried for parts which might contribute to restoration of other hand elements (Figs. 3-A and 3-B).

3. The elements of the index ray available to assume new roles by transfer are skin and soft tissues, fingernail and nail bed, digital nerves, first dorsal interosseus, first palmar interosseus, extensor digitorum, extensor indicus, flexor digitorum profundus, flexor digitorum superficialis, bone (phalanges and metacarpals), and joints.

4. Transfer of these elements should be considered at the time of initial wound treatment, and occasionally transfer may be carried out at that time. Parts which clearly cannot be used to restore the index finger can be saved for secondary procedures if the possibilities described in this article are considered initially.

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