Ask a Doctor: Fingertip Injuries

Hand surgeon Ryan Zimmerman, MD answers your questions about fingertip injuries.

What are fingertips made of?

Fingertips have several parts, all with special purposes.  At the core is the bone, called the distal phalanx, which provides support and shape to the end of the finger.  On the top and bottom of the bone are tendons that attach to the bone and make it move.  On the top rests the nail, supported by the specialized nail bed skin just below.  The rest of the fingertip is covered by skin that has lots of nerves, which give fingertips their sensitivity. 

Are fingertip injuries common?  How do they happen?

Fingertips are one of the most commonly injured body parts, and injuries can happen lots of different ways.  Two common ways are cuts, such as from a knife, or crush injuries, such as getting caught in a car door or under a heavy object. 

How are fingertip injuries treated?

Each injury is different, and the treatment depends on the parts of the fingertip that are injured.  Many injuries, especially those that injure only skin, are treated with bandages and time, allowing natural healing to occur.  Injuries to the nail or nailbed are often treated with a surgery to repair the nailbed.  Injuries that involve the bone, tendons or complete loss of the fingertip are sometimes treated with more involved surgery that can involve fixing the injured parts or even moving pieces of skin to cover the injured area.  Some fingertip injuries are bad enough that the fingertip cannot be saved, and the finger has to be shortened.  This is called an amputation

What is recovery like?  How long does it take?  Do injured fingertips look and work like normal once they heal?

Timing for healing depends on the severity of injury and the type of intervention required to fix it, as well as your health status.  For many injuries, it can take 4-6 weeks to be mostly healed, although the last bit of healing can take several more months.  Most fingertip injuries heal well, often back to normal or almost normal.  There are some exceptions.  Injuries that involve the nail or nailbed may cause the nail to fall off or look abnormal for 6 months or more.  Sometimes, the nail never returns to normal and looks different permanently.  Injuries that involve the bone can lead to permanent stiffness, where the fingertip does not bend all the way like it did before.  One common persistent problem with fingertips, especially after crush injuries, is they can be very sensitive to cold temperatures. 

I’ve had a fingertip injury.  What should I do? 

Your first step is usually to go to a nearby emergency room or urgent care center.  Then, if needed, you may require the assistance of a hand surgeon.  One way to find a hand surgeon in your area is via from the American Society for Surgery of the Hand.

Ryan Zimmerman, MD is a Hand, Shoulder and Elbow Surgeon and Greater Chesapeake Hand to Shoulder and the Curtis National Hand Center. 


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