Emulsified Fat Grafting to the Atrophic Post-traumatic Digital Pulp: A Promising Reconstruction Procedure

Introduction: Fingertips trauma are quite frequent. Whatever the initial surgical management, the follow-up often leads to cold intolerance and altered quality of life. In order to alleviate this symptom and improve everyday life, the authors consider grafting of emulsified autologous fat within the traumatized pulp. Methods: We prospectively reviewed 13 patients who underwent autologous fat grafts of traumatized digital pulp. We gathered 10 male and 3 female patients with median age of 41 years old (18–57). Median follow-up was 39 months (12–84). Patients with an isolated cosmetic complaint regarding their fingertip were excluded. Only patients with cold intolerance and altered quality of life were included. Assessment was first conducted at 6 months and then at a minimum of 12 months postoperative. We evaluated the cold intolerance with the visual analog scale (VAS) and the quality of life with the Quick-DASH questionnaire. Results: All our patients benefited from autologous fat grafting; 4 of them needed an additional grafting session. There was a significant improvement in the score of cold intolerance (p = 0.00232). Similar improvement was noted regarding the quality of life; Quick-DASH scores improved significantly between 6 and 12 months postoperative (p = 0.00166). No complications were noted. Conclusion: Autologous emulsified fat grafting to the traumatized pulp shows excellent results on cold intolerance and quality of life. This is systematic and easily reproducible. The benefit-risk ratio clearly seems to favor autologous fat grafting whose postoperative complications appear to be negligible.