When Are Digital Amputations Performed?

A digital amputation is the surgical removal of a portion of a finger, which can include the tip, end, or joint due to severe injury or elective surgery for a condition that has affected the finger.

A digital amputation involves surgical removal of a part of a finger.

Digital amputations are performed for the following conditions:

• Severe injury
• Severe infection (sepsis due to diabetic conditions)
• Ulcers
• Severe burns
• Tumors
• Restricted blood flow to a finger or digit (peripheral vascular disease)
• Malformations since birth

The goals involved in the treatment of digital amputations include:

• Preservation of function
• Preservation of the digit’s sensation
• Preservation of the nerves and other parts
• Early return to work
• Early prosthetic fitting

Digital amputations may sometimes occur after severe accidents. The doctor may try to reattach the amputated finger under general anesthesia. After thoroughly cleaning and preparing the wound, the surgeon may reattach the finger with stitches. 

The growth and function of the reattached finger always depend on the time from the accident and the age of the patient. The younger the patient the faster the recovery. 

When there is severe infection or a tumor, digital amputation is necessary to restrict further damage of other parts of the hands. This procedure is also done under general anesthesia. The affected fingers are cleansed and then surgically removed. The incisions are sutured and the patient is monitored for a few days in the hospital. 

In many cases, surgery can restore much of the sensation and function to the injured finger. However, if there are complications associated with the injury itself, then the patient might have complications. Possible risks and complications include:

• Infection
• Poor wound healing
• Persisting numbness or allergy
• Stiffness
• Abnormal growth
• Loss of function in the amputated part
• Painful nerve regeneration following the injury
• Adverse reaction to anesthesia (headache, drowsiness, and vomiting)

Usually, the effect on the use of the hand depends on how many fingers are involved in the digital amputation, as well as to what level the finger is amputated. 

A multiple-finger injury may cause a decrease in the ability to lift, carry, or manipulate objects. With single-finger involvement, the other fingers can assist as needed, but some strength and function may be lost. 

The amputation of a finger or fingers can be a difficult adjustment both physically and psychologically, and an individual may require support from a mental health professional or counselor afterward. 

Occasionally, job retraining may be necessary, and a hand therapist can assist in that process. Often single-finger amputation is considered to have a better prognosis than a multi-finger amputation.

After digital amputation patients are advised to:

• Get adequate rest
• Maintain adequate hydration and blood circulation volume
• Take painkillers for at least a week
• Keep the affected area elevated and warm
• Frequently monitoring the area for any color changes or signs of infection 
• Avoid dressing in the first 48 to 72 hours to minimize manipulation of the repair
• Patients may be placed on blood thinners such as aspirin. Some patients may require further surgery to improve the function.

On average, patients return to work within two to three months after a digital amputation. Studies show better functional recovery within three months, both in terms of movement and strength.