International Fingertip Amputation Project
Database Template
Version March 19, 1999
Explanation of coding convention used in this document:
Field number and field description [format of data in square brackets] (explanation in parentheses: first listing amount of space required and kind of field, that is, alphabetical or numeric, an explanation of field possibilities, and then explanation of field). For example, for the first field, the field number is 1, the field description is Center Identification number, the format of the data is shown in the square brackets [xx], the explanation of the two characters is two characters only, the explanation of the field possibilities is that the data will probably have numbers from 1-19, and that the data will be numeric data, not alphabetic data.
Item numbers and descriptions in BOLD are required fields.
PATIENT IDENTIFICATION
1) Center Identification number [xx] (two characters only, 1-19, numberical data)
(Each medical center will be given an ID number.)
2) Patient Identification [xxx] (three digits or letters only)
(Each center can decide how they want to ID each patient: three initials, an ID number, etc. We want to protect patient privacy, but be able to check the database for a particular patient, especially to update or change information.)
3) Free Field [X...x] (several lines; text field; non-scanable; need not be filled in.)
(This would not be a scanable field, but would let each center enter data that would show up on each printout of each record.)
4) Age in years (for children, use a decimal) [eg, 1.2] (two digits)
5) Sex [M,F] (one letter, either M or F)
6) Hand dominance [D, ND] (one or two letters, either D or ND)
7) Tobacco Use [Y, N] (one letter, Y or N; refers to any tobacco use, smoking or chewing)
8) Free field [X...x] (several lines; text field; non-scanable; need not be filled in)
INJURY IDENTIFICATION
9) Number of digits involved [1-10] (two digits)
10) Digit involved for this record [1-5] (one digit, 1= thumb, 2=index, etc. A new record will be needed for each finger involved, since each finger may be at a different level, be treated differently, etc. Field 7 will be scanable to determine if it is a single digit injury or multiple, in order to allow comparison of single and multiple digit recovery.
11) Classification [1-5, O (for other, not a zero)] O (Other): this classification should be used for injuries that do not fit well into this classification but might still be worthy of inclusion. For example, a patient who caught the tip of his finger in a grinder. Photographs will be essential for these patients. Class O patients will not be scanable.
International Fingertip Amputation Classification: Oblique
International Fingertip Amputation Classification: Transverse
International Fingertip Amputation Classification: Oblique
- Level 1: skin only
- Level 2: skin and nailbed; no bone
- Level 3: skin, nailbed, and bone distal to the proximal 1/3-middle 1/3 junction of the bone, based on xray; for the oblique injury, classify according to the majority of the finger, ie, if only 25% of the width of the finger is Level 4 and 75% is Level 3, classify as Level 3
- Level 4: skin, nailbed, and bone at or proximal to the above
- Level 5: proximal to any geminal matrix
(This system was proposed by Nelson and accepted by the Study Group at the first meeting in Vancouver.)
12) Obliquity [T, L, D, or V] (one letter, T=transverse, which means anything from 0 degrees to 30 degrees; L=lateral oblique, >30 degrees; D=dorsal oblique; V=volar oblique.
13) Mechanism: Sharp [S], Crush [C], Grinding [G], Twisting, Avulsion [T], Other [O]
14) Description [X...x] (several lines; text field; non-scanable field for narrative description; need not be filled in)
15) Size of defect (must be by direct measurement, not by guessing): __mm x __ mm.
16) Nail status: Fracture [Y,N]
17) Nailfold status: Eruption of nailplate, laceration, crush: [Y,N]
18) Nailbed status: Nailbed injured, subungual hematoma, crushed, etc.: [Y,N]
19) Fracture: [Y,N]
20) Description of co-morbidity [X...x] (several lines; text field; non-scanable field for narrative description; need not be filled in)
21) Nerve: [Y,N]
22) Description of co-morbidity [X...x] (several lines; text field; non-scanable field for narrative description; need not be filled in)
23) Tendon: [Y,N]
24) Description of co-morbidity [X...x] (several lines; text field; non-scanable field for narrative description; need not be filled in)
25) Other: [Y,N]
26) Description of co-morbidity [X...x] (several lines; text field; non-scanable field for narrative description; need not be filled in)
27) Estimate of use of hands [H, L] (one letter; Heavy or Light work)
28) Worker's Compensation Status [Y,N] (one letter, either Y or N)
29) Self-employed? [Y,N]
30) Free field for inclusion of photographs; non-scanable field (we will need to work on what formats will work. Must date and label. Need not be supplied. More on this topic later.)
31) Free field [X...x] (several lines; text field; non-scanable; need not be filled in)
TREATMENT INFORMATION
32) Date of Injury [mo/day/yr] [eg, 01/26/51 for January 26, 1951]
33) Date of Repair [mo/day/yr]
34) Days after injury repair was done [0, 1, ...] (three digits; 0=same day)
35) Surgeon Identifier [1,2,...99] (two digits. Each center could establish a list of surgeons and assign them a number from 1 to 99. The list does not need to be shared with the other centers, it will just allow a comparison of treatment by different surgeons. I will presume that 1=surgeon listed as main investigator.)
36) Surgeons's years of experience past formal training [1,2,...] (two digits; We may want to see if years of experience make any difference.)
37) Treatment [1,2,...] (two digits)
Treatment:
1 gauze dressing, dressing changes
2 Tegaderm or similar semipermeable dressing
3 nonpermeable dressing, eg, aluminum foil
4 shortening and closing, or just closing
5 STSG from amputated part
6 STSG from remote site
7 FTSG from amputated part
8 FTSG from remote site
9 composite graft
10 Atasoy
11 Kutler
12 Other VY flap
13 heterodigital neurovascular island flap
14 pulp heterodigital neurovascular island flap (AKA Littler or Moberg flap)
15 homodigital "
16 Classic Moberg volar advancement flap
17 reverse island flap
18 free flap
19 cross finger flap
20 thenar flap
21 abdominal or other distal flap
22 free pulp transfer
23 microvascular anastamosis
24 microvascular transfer of toe tissue
25 Kite flap
38) Shortening [0, 1, ...] (one digit; in mm)
39) Defect size [0.5, 1.0,...] (two digits; in sq cm)
40) Graft size [0.5, 1.0,...] (two digits; in sq cm)
41) Antibiotics: PO [Y,N]
42) Type:_________________
43) Antibiotics: PO length of treatment (days): ________
44) Antibiotics: parenteral type: ___________
45) Any additional risk for infection? [Y,N]
46) Specify:___________________________________________________________________ _________________________________________________________________________
47) Primary surgery sucessful [Y, N] (one letter, either Y or N; N=revision surgery suggested)
48) Revision procedure [list as in 21] (two digits)
49) Other complication [X...x] (several lines; this is the place to explain 28 or put in something that we did not list; non-scanable field)
50) Outcome of secondary procedure: sucessful [Y, N] (one letter, either Y or N)
51) Outcome of secondary procedure: other complications [same as 28)
52) Time after index surgical treatment healed [in mo.s] (if it heals in one week, put 0.25) (four digits; "healed" means "when the dressings come off and stay off." )
53) Free field for inclusion of photographs; non-scanable (we will need to work on what formats will work. More on this later. Need not be supplied.)
54) Free field [X...x] (several lines; text field; non-scanable; need not be filled in)
WORK STATUS
55) Time after initial treatment returned to light work [1, 2, ..] (two digits or a letter; in months{not weeks}; N=never)
56) Time after initial treatment returned to normal work [as above]
57) Changed jobs [Y, N]
58) Description [X...x] (several lines; text field; non-scanable; need not be filled in)
59) Free field [X...x] (several lines; text field; non-scanable; need not be filled in)
THREE MONTH FOLLOW-UP
60) If the patient actually plateaued prior to three months, enter time patient plateaued in weeks after injury [xx] (weeks)
61) Donor site morbitity [Y, N]
62) Description [X...x] (several lines; text field; non-scanable; need not be filled in)
63) Pain at amputation site [0, 1, ..10] (Use a pain scale of 0 to 10, with 10 being the greatest pain the patient could experience, 0 obviously being no pain)
0=none
1=light pressure nontender, firm pressure is mildly tender but does not interfere at all with activities
2=light pressure nontender, firm pressure is painful but minimal handicap with activities
3=light pressure nontender, firm pressure is painful and causes slight handicap with activities
4=light pressure is tender and objectionable, but only slightly avoided
5=light pressure is painful and avoided, but activities minimally affected
6=light pressure is painful and avoided, activities slightly affected
7=light pressure is painful and avoided, activities significantly affected
8=occasional pain at rest, modifies use of hand to avoid many activities
9=frequent pain at rest, modifies use of hand to avoid most activities
10=worst possible pain; no use of finger possible; simply touching tip to cloth is so painful that patient makes sure it does not happen
64) Tenderness in any incision site (other than the fingertip) [0, 1, ...10]
65) Nail Deformity, Description [0, 1, 2...] (one digit; 0=none, 1=parrot beak, 2=split, 3=shortened)
66) Nail Deformity, Surgeon's Opinion [0, 1, 2...] (one digit; 0=none, 1=minor abnormality, minimally noticeable but not perfect; 2=minor abnormality, noticeable; 3=abnormality, noticeable easily; 4=so deformed as to be unacceptable)
67) Nail Deformity, Patient's Opinion [0, 1, 2...] (one digit; 0=none, 1=minor abnormality, minimally noticeable but not perfect; 2=minor abnormality, noticeable but not objectionable to patient; 3=abnormality, noticeable easily and objectionable to patient but does not want revision; 4=significant abnormality, patient is unhappy, possibly wants or is considering revision)
68) Cold Sensitivity [0, 1, 2,...] (one digit; 0=none, 1=mild sensitivity, does not interfere with ADL or work; 2=moderate sensitivity, slightly interferes with ADL or work but does not prevent activities; 3=severed sensitivity, interferes with ADL or work)
69) Range of Motion [xx] (two digits; mm; distance tip {presume normal length of digit} is from distal palmar crease)
70) Other complications [0,1,...]
0 none
1 = superficial infection
2 = deep infection
3 = other ___________________
71) Sensation: Two-point discrimination [2, 3, ...] (in mm)
72) Comparison Sensation in opposite normal digit [2, 3, ...] (in mm; ie, if the index finger is injured, compare to the opposite index finger)
73) Sensation: Semmes-Weinstein monofilaments [2.83, 3.62,...]
74) Comparison Sensation in opposite normal digit [2.83, 3.62,...]
75) Durability of skin coverage [1, 2, 3] (1=durable, 2=fair, 3=poor)
76) Overall Cosmesis, Surgeon's Opinion: [1, 2,...6]
1 looks great
2 minimally noticeable
3 noticeable but OK
4 noticeable, poor
5 ugly
6 needs revision
77) Overall Cosmesis, Patient's Opinion [1, 2, ...6] (use rating as above, read to patient, no coaching; obviously, read in proper language if not English)
78) Overall surgeon satisfaction [1, 2,...4] (1=excellent, 2=good, 3=fair, 4=poor)
79) Overall patient satisfaction [1, 2,...4] (1=excellent, 2=good, 3=fair, 4=poor)
80) Does injury interfere with Activities of Daily Living? [1,2,...] (1=no, 2=minimal, 3=somewhat, 4=most activities)
81) Does injury interfere with Activities of Recreation? [1,2,...] (1=no, 2=minimal, 3=somewhat, 4=most activities)
82) Does injury interfere with Activities of Work? [1,2,...] (1=no, 2=minimal, 3=somewhat, 4=most activities)
83) Patient's overall satisfaction [1, 2, ...] (with overall result, all things considered)
1=very satisfied
2=fairly satisfied
3=partly satisfied
4=not satisfied
84) Free field for inclusion of photographs; non-scanable (we will need to work on what formats will work. More on this later. Need not be supplied.)
85) Free field [X...x] (several lines; text field; non-scanable; need not be filled in)
SIX MONTH FOLLOW-UP
86) ...repeat the three month criteria, including free field for photographs, need not be supplied
TWELVE MONTH FOLLOW-UP
87) ...repeat the three month criteria, including free field for photographs, need not be supplied
