Finger Pain - Dislocated Finger
Answer: B.
This patient has a simple finger dislocation (B). After adequate analgesia (systemic or digital nerve block), reduction is achieved by gentle constant traction. If the relocation is not smooth or immediate, there may be entrapped soft tissue or bony fragments (which would then be dealt with in the OR).
The interphalangeal joints of the fingers are flanked by lateral collateral ligaments and a fibrous volar plate. There is very little support on the dorsal surface, which explains why most finger dislocations are dorsal.
His radiographic exam was:
After reduction, re-examine for ligamentous laxity. Splint in 20-30 degrees of flexion, with close follow-up with Orthopedics. Open injuries or non-reducible injuries need emergent Orthopedic involvement (A).
Splint and refer (C) and warm water soaking (E) delay treatment and therefore increase the overall morbidity and the need for surgical intervention. This deformity was associated with (relatively minor) trauma, and not an indolent medical course (D).
This patient has a simple finger dislocation (B). After adequate analgesia (systemic or digital nerve block), reduction is achieved by gentle constant traction. If the relocation is not smooth or immediate, there may be entrapped soft tissue or bony fragments (which would then be dealt with in the OR).
The interphalangeal joints of the fingers are flanked by lateral collateral ligaments and a fibrous volar plate. There is very little support on the dorsal surface, which explains why most finger dislocations are dorsal.
His radiographic exam was:
After reduction, re-examine for ligamentous laxity. Splint in 20-30 degrees of flexion, with close follow-up with Orthopedics. Open injuries or non-reducible injuries need emergent Orthopedic involvement (A).
Splint and refer (C) and warm water soaking (E) delay treatment and therefore increase the overall morbidity and the need for surgical intervention. This deformity was associated with (relatively minor) trauma, and not an indolent medical course (D).