{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:43Z","timestamp":1787755843172,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Most patients recover well following fingertip injuries. Outcomes vary along a spectrum, influenced by both pathophysiological severity and psychosocial factors, which strongly influence patient-reported outcome measures (PROMs). General instruments (e.g., Disabilities of the Arm, Shoulder, and Hand [DASH]; Michigan Hand Questionnaire [MHQ]; and Patient-Reported Outcomes Measurement Information System [PROMIS]) are reliable but often overlook fingertip-specific concerns such as nail deformity, cold intolerance, pulp loss, or subtle sensory changes. To address this gap, the Fingertip Injuries Outcome Score (FIOS) was developed, integrating objective domains (grip strength, range of motion, 2-point discrimination [2PD], and bone union) with patient-reported domains (nail esthetics, sensibility, cold intolerance, pain, and return to work), providing a fingertip-specific assessment. This study systematically reviews outcome scoring systems for fingertip injuries, evaluating their validity, reliability, responsiveness, and clinical utility, with a particular focus on the FIOS-the only instrument specifically designed for fingertip injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic search (PubMed, Scopus, Web of Science; up to December 2024) identified studies evaluating fingertip injuries with defined outcome scores. Data included score domains, psychometrics, and applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>FIOS was the only fingertip-specific score identified, demonstrating strong internal consistency (Cronbach \u03b1 = 0.796) and excellent interrater reliability (\u03ba = 0.844) in its validation study (n = 199), with 93% of patients achieving excellent or good outcomes. An independent pilot (n = 58) confirmed its sensitivity to injury severity. Subgroup analysis showed no significant difference in FIOS outcome distribution across injury mechanisms, though whether this reflects robustness or limited discrimination requires study. General PROMs (MHQ, DASH, Hand20, and PROMIS) each had high internal consistency (\u03b1 \u2265 0.90) and correlated strongly with psychosocial factors but lacked fingertip-specific coverage. The Hand Injury Severity Score correlated with MHQ but served only as a severity index. By integrating objective and patient-reported domains, FIOS is the most fingertip-specific assessment available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>FIOS is the most complete fingertip-specific outcome instrument and should be adopted as the primary standard for outcome reporting and long-term follow-up across fingertip injuries. For comprehensive assessment, pair FIOS with a general hand\/upper-extremity PROM and objective tests (e.g., 2PD, ROM\/TAM, and grip strength). Standardizing on FIOS in practice, registries, and trials will harmonize reporting for current and future cohorts and enable clearer comparisons across treatments. While further multicenter validation and responsiveness\/minimal clinically important difference estimates remain priorities, the need for a fingertip-specific standard justifies adopting FIOS now with ongoing evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . Systematic review of cohort and observational studies without randomized controlled trials. See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.25.00128","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T19:00:34Z","timestamp":1763146834000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Outcome Scores for Fingertip Injuries"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3321-9255","authenticated-orcid":false,"given":"J. Terrence Jose","family":"Jerome","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Dhanalakshmi Srinivasan Medical College, Hospital, Siruvachur, Perambalur, Tamilnadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8957-3695","authenticated-orcid":false,"given":"G.","family":"Surendran","sequence":"additional","affiliation":[{"name":"Trichy SRM Medical college, Irungalur, Trichy, Tamilnadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thirumagal","family":"Kuppusamy","sequence":"additional","affiliation":[{"name":"Olympia Hospital & Research Centre, Trichy, Tamilnadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11]]},"reference":[{"issue":"1","key":"r1-20251114","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1186\/s13018-021-02571-7","article-title":"The Michigan Hand Outcomes Questionnaire (MHQ-Swe) in patients with distal radius fractures: cross-cultural adaptation to Swedish, validation and reliability","volume":"16","author":"Blomstrand","year":"2021","journal-title":"J Orthop Surg Res"},{"issue":"6","key":"r2-20251114","doi-asserted-by":"crossref","first-page":"e4386","DOI":"10.1097\/GOX.0000000000004386","article-title":"Fingertip injuries outcome score","volume":"10","author":"Jerome","year":"2022","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"7","key":"r3-20251114","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1302\/0301-620X.92B7.23410","article-title":"Development and validation of an illustrated questionnaire to evaluate disabilities of the upper limb","volume":"92","author":"Suzuki","year":"2010","journal-title":"J Bone Joint Surg Br"},{"issue":"1","key":"r4-20251114","doi-asserted-by":"crossref","first-page":"60","DOI":"10.18203\/issn.2455-4510.IntJResOrthop20243453","article-title":"A comprehensive study of fingertip injuries at a tertiary care centre: fingertip injury outcome score subset pilot","volume":"11","author":"Soujanya","year":"2024","journal-title":"Int J Res Orthop"},{"issue":"11","key":"r5-20251114","doi-asserted-by":"crossref","first-page":"e5407","DOI":"10.1097\/GOX.0000000000005407","article-title":"A prospective follow-up study of fingertip amputation treatment with semi-occlusive dressing","volume":"11","author":"Rautio","year":"2023","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"1","key":"r6-20251114","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s00068-020-01462-6","article-title":"Reconstruction of motorcycle spokes wheel injury fingertip amputations with reposition flap technique: a report of 40 cases","volume":"48","author":"Jerome","year":"2022","journal-title":"Eur J Trauma Emerg Surg"},{"key":"r7-20251114","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"issue":"4","key":"r8-20251114","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s11136-010-9606-8","article-title":"The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study","volume":"19","author":"Mokkink","year":"2010","journal-title":"Qual Life Res"},{"issue":"5","key":"r9-20251114","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s11136-018-1798-3","article-title":"COSMIN guideline for systematic reviews of patient-reported outcome measures","volume":"27","author":"Prinsen","year":"2018","journal-title":"Qual Life Res"},{"issue":"6","key":"r11-20251114","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1097\/00000637-199906000-00006","article-title":"The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change","volume":"42","author":"Chung","year":"1999","journal-title":"Ann Plast Surg"},{"issue":"1","key":"r12-20251114","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/1753193419882875","article-title":"Which patient-reported outcomes shall we use in hand surgery?","volume":"45","author":"Marks","year":"2020","journal-title":"J Hand Surg Eur Vol"},{"issue":"4","key":"r13-20251114","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.jcot.2020.05.026","article-title":"Correlation of HISS and Strickland Score with the Michigan Hand Outcome Questionnaire in hand injuries","volume":"11","author":"Bhat","year":"2020","journal-title":"J Clin Orthop Trauma"},{"issue":"5","key":"r14-20251114","doi-asserted-by":"crossref","first-page":"e2256","DOI":"10.1097\/GOX.0000000000002256","article-title":"Site-specific patient-reported outcome measures for hand conditions: systematic review of development and psychometric properties","volume":"7","author":"Wormald","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"5","key":"r15-20251114","doi-asserted-by":"crossref","first-page":"746e","DOI":"10.1097\/PRS.0000000000000591","article-title":"Measuring outcomes and determining long-term disability after revision amputation for treatment of traumatic finger and thumb amputation injuries","volume":"134","author":"Giladi","year":"2014","journal-title":"Plast Reconstr Surg"},{"issue":"9","key":"r16-20251114","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1177\/17531934231172081","article-title":"Long-term patient-reported outcome measures of fingertip coverage with a homodigital unipedicle neurovascular island flap","volume":"48","author":"Rob","year":"2023","journal-title":"J Hand Surg Eur Vol"},{"issue":"4","key":"r17-20251114","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1177\/17531934231215626","article-title":"Long-term patient-reported outcome measures of fingertip coverage with a homodigital unipedicle neurovascular island flap","volume":"49","author":"Jerome","year":"2024","journal-title":"J Hand Surg Eur Vol"},{"issue":"2","key":"r18-20251114","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jhsg.2024.02.018","article-title":"Retrospective analysis of functional outcome of distal fingertip replants without heparin","volume":"7","author":"Jithendran","year":"2025","journal-title":"J Hand Surg Glob Online"},{"issue":"6","key":"r19-20251114","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.hansur.2023.08.008","article-title":"Semi-occlusive dressing versus surgery in fingertip injuries: a randomized controlled trial","volume":"42","author":"Bensa","year":"2023","journal-title":"Hand Surg Rehabil"},{"issue":"2","key":"r20-20251114","doi-asserted-by":"crossref","first-page":"101671","DOI":"10.1016\/j.hansur.2024.101671","article-title":"Correspondence to: Bensa M, Sapa MC, Al Ansari R, Liverneaux P and Facca S: semi-occlusive dressing versus surgery in fingertip injuries: a randomized controlled trial. Hand Surg Rehabil. 2023;42:524-29","volume":"43","author":"Jerome","year":"2024","journal-title":"Hand Surg Rehabil"},{"key":"r21-20251114","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/14604086251333533","article-title":"Dorsoulnar flap for non-replantable Allen type 3 and 4 thumb amputations: retrospective analysis of 15 cases","volume":"27","author":"Terrence Jose Jerome","year":"2025","journal-title":"Trauma"},{"key":"r22-20251114","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.bjps.2024.03.019","article-title":"Comparing clinical and aesthetic outcomes of cross-finger and homodigital reverse digital artery island flap for fingertip injuries: a single-center retrospective cohort study","volume":"95","author":"Kuwahara","year":"2024","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"6","key":"r23-20251114","doi-asserted-by":"crossref","first-page":"e6909","DOI":"10.1097\/GOX.0000000000006909","article-title":"Evaluation of biodegradable temporizing matrix for functional and aesthetic outcomes in hand soft-tissue defect: a 3-year retrospective study","volume":"13","author":"Omar","year":"2025","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"5","key":"r24-20251114","doi-asserted-by":"crossref","first-page":"100319","DOI":"10.1016\/j.jham.2025.100319","article-title":"Thumb tip reconstruction for apical substance loss using a bipedunculated homodigital V-Y advancement flap: our experiences","volume":"17","author":"De Francesco","year":"2025","journal-title":"J Hand Microsurg"}],"container-title":["JBJS Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.25.00128","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:53:00Z","timestamp":1787752380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.25.00128"}},"subtitle":["A Systematic Review"],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":23,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.rvw.25.00128","relation":{},"ISSN":["2329-9185"],"issn-type":[{"value":"2329-9185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}