A 24-year-old male presented to our hospital, with a shearing, crush-type injury to multiple fingertips of the right hand, resulting in exposed distal phalanges of the middle, ring, and small fingers. The amputated distal stumps were retrieved, but due to the nature of the injury, replantation was not possible. The patient was a healthy, non-smoker, without signs of tinea pedis or unguium. A variety of reconstruction strategies were presented to the patient and his family, including stump revision amputation, V-Y flap advancement, and pedicle or free flap coverage.