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A Novel, Less-Invasive Treatment Option for Traumatic Fingertip Amputations
Carlton Clinkscales, MD; J. Logan Brock, MD
Hand Surgery Associates, Englewood, CO

Introduction: Many treatment options for traumatic fingertip amputations are available to the surgeon, each with its advantages and disadvantages. Powdered porcine urinary bladder matrix (UBM) is a novel product that has shown promise for improving outcomes in a wide variety of settings. We hypothesize that powdered porcine UBM is a novel and viable treatment option for fingertip amputations because it is safe, effective, and well tolerated, providing successful healing and preserving maximum length.
Methods: UBM powder was applied to patients presenting with fingertip amputation injuries to the senior author's clinical practice. The treatment was used on 7 patients over the course of 3 years (2011 to 2014). Powdered porcine UBM was applied regularly until the digit healed. The total number of applications ranged from 3 to 31. Complications, presence or absence of neuroma, final range of motion, and DASH (Disabilities of the Arm, Shoulder, and Hand) scores were recorded. Patient satisfaction was determined through follow-up patient surveys. Statistical analysis was performed. Complication rates, incidence of neuroma, average time to healing, and the results of the DASH assessment were recorded.
Results: Ultimately, 86% of patients returned for follow-up. All returning patients displayed successful healing of the digit with maximum length preserved. Notably, there were no complications encountered. No patients had to undergo secondary operations. Additionally, there was no incidence of neuroma. No allergic reactions occurred. Significantly, these results came from a patient series with diverse mechanisms of injury and a range of comorbidities. Affected fingers treated with UBM showed excellent recovery, with maximum length preserved and healthy tissue growth in the affected regions. Time to healing averaged 54.33 days, with a standard deviation of 33.03 days. This time period varied with the severity of the injury.
Conclusions: Porcine UBM powder provided successful healing while preserving maximum length in a series of patients presenting with traumatic finger amputations. In addition to its marked efficacy, the treatment proceeded without any complications. It was well tolerated and patients were highly satisfied. Each case displayed complete and successful healing. The application of porcine UBM is a novel, advantageous, non-operative approach to the treatment of finger amputations that is safe and effective. Porcine UBM application is a promising non-operative alternative to the current treatment options for traumatic finger amputations.

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