A simple technique for injecting the small joints of the fingers and thumb using finger traps for traction

Abstract

BACKGROUNDDigital amputation (also known as 'digital terminalisation') is a common procedure carried out by plastic surgeons and orthopaedic surgeons. The aim in these procedures is to maximise function by preserving the length and sensibility of bone, and to provide robust soft-tissue coverage of the bony stump. Here, we describe a simple technique to protect soft tissues during digital amputation. TECHNIQUEOne layer of a sterile surgical glove is cut into a square of dimension 4cm  4cm. Then, this square is folded in half and a cut of 5mm made halfway along the folded edge. This action leaves a hole in the centre of the square when unfolded (Fig 1). Once the digit has been prepared, the central hole is placed over the exposed bone end (Fig 2). The surrounding square is pushed down on top of soft tissues to protect them. Then, the surgeon can use an oscillating saw to cut through the bone safely. DISCUSSIONHere, we describe an inexpensive, simple soft-tissue guard made from a section of glove. This guard helps to prevent inadvertent damage to soft-tissue flaps, and provides a clear aid to saw through bone at the desired level confidently. We have used this soft-tissue guard in emergency and elective settings, and found it helpful for surgeons at all levels of experience.