Upper Extremity Injuries are very common in an occupational setting. Upper Extremity Injuries can include injuries to the fingertip. Fingertip injuries can involve an amputation.
In the general population, “[i]t is estimated that as many as 45,000 finger amputations are performed in the US per year with an incidence rate of 7.5/100,000 people.” Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):e8291. Published 2020 May 26. doi:10.7759/cureus.8291
This article will discuss Fingertip Injuries, causes of fingertip injuries, treatment for fingertip injuries, a special workers’ compensation law with respect to amputation cases, and issues relating permanent disability.
What is the Fingertip? Why is It Unique?
Fingertips are unique. “The tip of the digit comprises virtually all tissue components present elsewhere in the body: skin, bone, joint, synovial membrane, ligaments, tendons, tendon sheaths, arteries, veins, lymphatic channels, nerves, and advanced nervous end organs.” Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):e8291. Published 2020 May 26. doi:10.7759/cureus.8291
Thus, a traumatized tip can experience a variety of symptoms. These symptoms and factors of impairment can include tenderness, sensitivity to cold, discoloration, and deformity. Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):e8291. Published 2020 May 26. doi:10.7759/cureus.8291
What Are Common Causes of Fingertip Injuries?
Many occupational hand injuries involve metal items. The metal items can include hand tools which include blades. On a personal note, I have had fingertip injuries occur on table saws in which safeties have been removed. Also, I have had fingertip injuries in which the hand accidentally went into a piece of moving machinery.
Fingertip injuries can also occur as a result of sharps. Sharps are devices that are used to cut. These include many items used in the medical field such as auto injectors, connection needles and sets, infusion sets, lancets, needles, and syringes.
Sharp injuries can result in lacerations, amputations, or neurovascular injuries. Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):e8291. Published 2020 May 26. doi:10.7759/cureus.8291
What Are Goals of Treatment?
Treatment goals for fingertip injuries include restoration of sensation of the tip, improving the durability of the tip, and providing for proper bone support to allow for nail growth. Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):e8291. Published 2020 May 26. doi:10.7759/cureus.8291
What Problems Can Arise from a Fingertip Injury?
Problems arising from fingertip injuries can include deformities, intolerance to cold, skin tenderness, stiffness, and long-term functional loss. Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):e8291. Published 2020 May 26. doi:10.7759/cureus.8291
How Is a Fingertip Injury Treated?
Due to the complexity and importance of the fingertip, there are many issues that can present. There are concerns with respect to psychological factors that can present with such injuries.
Also, there may be issues of pain syndromes that can occur as a result of a fingertip injury. These pain syndromes can even occur in the case of minor contusion. Approach to Fingertip Injuries Patricia Martin-Playa, MD, Anthony Foo, MD* Clin Plastic Surg 46 (2019) 275–283 https://doi.org/10.1016/j.cps.2019.02.001
Treatment can include repairing the skin by stiches or glue, skin grafting, reconstruction, composite grafts, flap reconstruction, bone graft, nail complex reconstruction.
Are There Psycho-Social Factors Issues with Fingertip Injuries?
Yes. Fingertips are an extremely important part of the body. They are used frequently during the day for a variety of tasks. Fingertip injuries can impact one’s occupation and their participation in hobbies. For example, a fingertip injury may impact on one’s ability to perform a musical instrument.
Fingertips are usually visible to the public. Therefore, there can be an emotional impact on the patient.
Fingertip injuries that are part of a workers’ compensations have secondary motivation issues. For instance, the patient may have concerns about disability status and impairment.
Fingertip injuries can be subject to clinical bias. For example, medical practitioners may view the severity of the injury differently from the patient. Approach to Fingertip Injuries Patricia Martin-Playa, MD, Anthony Foo, MD* Clin Plastic Surg 46 (2019) 275–283 https://doi.org/10.1016/j.cps.2019.02.001
Is There a Special Law for Amputation Cases?
Yes. In the case of amputations, total temporary disability benefits are extended out to 240 weeks from 104 weeks. This is pursuant to Labor Code Section 4565(c)(3)(c.)
What Type of Permanent Impairment Can Arise from A Fingertip Injury?
Fingertip injuries can cause many types of impairments. There are impairments that relate to amputations, there are impairments that relate to skin conditions, there are impairments that relate to nerve damage, there are impairments which relate to loss of function such as range of motion. Also, there may be a pain impairment add-on.
What if I Need Advice?
If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.