Long-term functional outcome after conservative management of a fingertip amputation with exposed bone, using a semi-occlusive dressing: a case report

Introduction and importance: Semi-occlusive dressings are established for selected fingertip amputations with exposed bone. Because this treatment is well described, the value of single-case reports depends on documenting the course, limitations, and long-term sequelae. Case presentation: A 47-year-old right-hand-dominant man presented to primary care after a mandoline-slicer injury causing partial amputation of the right little fingertip, with an exposed distal phalanx and a preserved nail bed, clinically consistent with an Allen type II injury. A transparent, semi-occlusive polyurethane dressing was applied and changed weekly. No systemic antibiotics were prescribed. Clinical discussion: The exposed bone was clinically covered by week 4, and near-complete pulp reconstruction was observed by week 6. At a 6-year in-person follow-up, following telephone contact, the patient reported no sick leave, pain 0/10, no cold intolerance, a complete active range of motion, and no secondary surgery, infection, or clinical evidence of osteomyelitis. The QuickDASH score was 2.3/100. Sequelae included a mild reduction in temperature and pressure perception, minor typing adaptation, and a subtle lateral nail-growth alteration of approximately 2 mm. Conclusion: This single selected case documents a favorable 6-year outcome after conservative management. No general conclusion regarding treatment effectiveness can be drawn from a single case.