Hello, I will try and put as much information as

Patient

Q: Hello, I will try and put as much information as I can due to the fact that I have a lot of questions. I had a very bad crush injury to my index finger back in January. The skin had split open all the way to the bone and the pip join in the finger was broken/crushed. I was taken in to surgery the same day and they thought that all the problems were fixed.

2 weeks later I developed necortic skin at the very tip of the finger. I asked what it was and I was given no answer. A week after that i was told that my finger had to be amputated due to the fact that I had no blood flow. I fought against it because I felt like there was other things that could be done prior to doing a full amputation. So we kept waiting for about 4 more weeks, finally my doctor to me to make a choice and I said I wanted my finger. After that he came up with many different things we could try... any how we found out that because we had waited so long I had some tissue lost in the middle of the finger.

So in early march I went in to surgery again for debridement and they were able to save my finger. well most of it. now that the back story is done here are my questions. according to my records they said they took about 1cmx3cm of skin from the palm side of my finger, but only went as deep at 4mm in. The didn't say how much they shaved off the top but I don't think it was much but as of right now I missing about 4mm/5mm of teh top compared to my other index finger.

Will this skin grow back? I have read place where as long as you have the nail matrix it will but I am curious as to if all of it will grow back and it's just taking a long time, or if my finger will be forever short. And is there anything I can do to make sure the skin grows back?

Now with the skin they took off the top they took my nail bed also. Will I have to get a nail bed graft or will a new one grow in while the skin grows back? My nail is growing on that finger also. And is there a less surgical way of fixing the nail bed since I would only be missing 4mm/5mm of it if the skin grows back without it?

Now the pip joint has healed to the point that it looks basically normal on a xray but I was told that I have no cartilage there. Can I get say a cartilage replacement instead of a full out joint replacemnt? I ask this because I am only 22 years old and I know that joint replacements do not do so well in that joint in the index finger because of how much it gets used so I want something that will last 4-5 years instead of just 2. Also I am looking for something that will leave me with options down the line if I need to get more stuff done to that joint later on.

The dip joint on the index finger I now suspect is in a mallet finger form. It did not start out that way but through my physical therapy I feel that too much pressure was appiled to it and now it is stuck in the position. Now I can flex it a litte but I can not extend it. My physical therapist hasnt said anything about it but due to how I was treated earlier on at this hospital I feel like they are trying to get my to take the easy way out instead of fighting my way back to normal. or at least as close as I can get to it. But back to the question, is there anything that can be done for this joint. I did not have any tendon damage in my accident and its been longer then 6 weeks so the special splint I read about was said to be ineffective after that time so I am wondering there is anything that can be done about that or if it will get better with therapy?

I have also noticed that I have started losing "weight" in this finger. I am not sure what else to call it but the finger is getting skinnier as the weeks go by. I know that when there is an injured part of the body this is normal but I was wondering if after all is said and done if it will fill back out or if I will have to get a fat transplant or something to fix it?

Last question, this goes back to the skin growing back questions. The back side of my finger(palm side) is missing a lot of skin I think. Its hard to tell really, but I want to say maybe all 5 layers of the epidermis, but I was wondering if that will come back with time also? I have a scar on that side, its pretty big, it doesnt cover they entire back side but it takes up about 40 percent maybe, and I know that once you get scar tissue it never goes back to normal, so if that is true is there a scar removal surgery I can get that would take the scar of and replace it with some tissue or skin graft from another finger to hopefully restore the natural cycle of the fingers skin renewal?

I understand that my finger will never be exactly like it was before and I should just be happy that I have as much of it as I do, but since I had to fight to keep that much of it I want to to try and get my finger as close to normal as I can get it. Also I have normal feeling all over the finger and the color on the side with the nail is normal. that palm side is either pale or redish depending where you look.

Doctor

A:   This question is currently in queue and will be answered shortly by one of our doctors. In the meantime you may browse our library of answered questions by clicking here.

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