Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.Amputation of digits is not a common procedure, but it is an important consideration in the treatment of tumors, persistent infection, and the sequelae of severe digital trauma. Most distal amputations are performed with skeletal shortening and primary closure. With pathology at the level of the proximal phalanx, a decision must be made to either preserve the remaining digit or perform a ray resection. When an amputation can be performed close to the proximal interphalangeal (PIP) joint, some useful gripping function may be preserved. However, for more proximal levels or when the metacarpophalangeal (MCP) joint is affected a ray resection is usually the procedure of choice. In this video, Dr. Orfaly presents an index finger ray resection performed to treat a painful and stiff digit approximately 6 months following a severe crushing injury. Technical details with specific attention to soft tissue handling are demonstrated, and the post-operative treatment plan and expected outcomes are discussed.