Injury or amputation of the fingertip can have a negative effect on the overall function of the hand. Fingertip injury and amputations are not uncommon.  These injuries can be very painful and debilitating and need to be properly cared for.  The fingertip is very sensitive and important to the function of the finger; it allows us to grip, feel and discriminate between different objects.  We often see finger tip injuries and know exactly how to get you back on track to using your hand quickly and effectively. Did you know the thumb and fingers on your hand have different and important responsibilities in the overall function of the hand?

·         Thumb: Accounts for approximately 40-50% of overall hand function. Important for opposition and stability

·         Index Finger: Important for stability and balance in fine motor tasks

·         Middle Finger: Support the index finger and provides a cupping action.

·         Ring Finger: Works with little finger to provide power grip. Prevents objects falling from the hand

·         Little Finger: Works with the index finger to provide power grip and helps to control fine motor activity.

Fingertip amputations are a common injury to the hand, occurring regularly at work and in the home. Injuries are classified according to how much of the fingertip has been amputated and the direction of the amputation. They can be divided into 3 categories depending on the mechanism of the injury:

·         Clean cut: Sharp object, no tissue loss and minimal crush damage to amputated tip, eg, knife.

·         Crush cut: Blunt object, some tissue loss and crush damage to amputated tip, eg, saw, door.

·         Crush avulsion: Severe crush damage or avulsion, eg, machine press, door.

It is important that following a finger tip injury, you spend some time in hand therapy so you can regain as much function and sensation as possible in your fingertip. Here in hand therapy, we help with:

·        Wound care: This will include regular dressing changes to keep the wound clean and dry and allow it to heal well. Once the wound has healed, you will begin scar massage, to ensure any scar tissue remains supple and smooth. Hand therapy can also ensure your scar does not stick to any structures in your finger and prevent movement.

·       Splinting: Depending on your injury, your therapist may provide you with a small plastic custom-made splint. This will immobilise your fingertip and protect it as it is healing and provide a shield in case you bump the end of the finger on things.  Often, our splints are removable to allow exercises and once your wound heals, allows you to shower freely.

·       Desensitisation: When injured, your nerves can become irritated and hypersensitive causing pain and discomfort. The use of different environmental textures as well as tools, such as vibration and texture stick will help to settle your nerves and train your brain to react normally to touch.

·        Movement: As soon as possible after your injury your therapist will have you exercising your finger. This is important to prevent tightness and stiffness in the joints and to ensure you regain as much function in your hand as possible.

The take home message is the earlier you can get to therapy, the earlier you can get back to all the normal things you love doing.  

And... if you come across someone with a finger tip injury or amputation, they may be experiencing pain and loss of function, so comments like, "It's only a little finger." should be avoided. The little finger is the master of strength and should never be underestimated!       

Thank you to Rebecca, our recent Masters of Occupational Therapy student for this contribution!