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A 39-year-old male sustained an index finger injury 6 months ago and has failed eight weeks of splinting. A radiograph taken at the time of injury is shown in Figure A, and a current radiograph is shown in Figure B. Which of the following is true regarding open reduction and screw fixation of this injury?
High risk of symptomatic implant
Immobilization of the distal interphalangeal joint is required for 2 weeks post-operatively
High rates of post-operative infection are common
Open reduction via an approach through the nail bed leads to significant post-operative nail deformity
Range of motion of the DIP joint in the affected finger is usually less than 10 degrees post-operatively
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What is the most frequently encountered form of osseous injury associated with dorsal proximal interphalangeal joint(PIP) fracture-dislocations?
Middle phalanx palmar lip fractures
Proximal phalanx extraarticular fractures
Middle phalanx dorsal lip fractures
Middle phalanx dorsal and palmar lip fractures (pilon)
Proximal phalanx palmar lip fractures
A 28-year-old professional baseball player injures his middle finger sliding into the catchers shin guard at home plate. He complains of pain and deformity of the middle finger. A radiograph is provided in figure A. All of the following are true EXCEPT:
Anatomic reconstruction of the articular surface is prognostic of clinical function
Proximal interphalangeal joint subluxation precludes a normal gliding flexion arc
Hinging at the fracture site must be avoided
Early motion should be initiated in postoperative therapy
Early degenerative arthritis can be expected if the joint is not adequately reduced.
A 20-year-old football player presents with a one week history of right index finger pain which started after his hand got caught in a face mask during a tackle. Physical exam shows swelling of the digit with no breaks in the skin, and no active flexion. AP, lateral, and oblique radiographs are provided in Figures A, B, and C respectively. Which of the following structures most often prevents closed reduction of this injury?
A 27-year-old man falls on his hand at work. He notices an immediate deformity of his ring finger. Radiographs are provided in Figure A. Which of the following is the most appropriate initial treatment?
Closed reduction, buddy taping, and early motion to prevent stiffness
Closed reduction and full time extension splinting
Open reduction and repair of the central slip of the extensor tendon
Open reduction and repair of the volar plate
Amputation and immediate return to work
A collegiate baseball player injures his left small finger sliding into third base. He complains of pain and swelling. The finger is ecchymotic, swollen throughout, and painful with attempted range of motion of the PIP joint. No sensory or vascular deficits are present. A radiograph is provided in Figure A. Which of the following interventions will provide the best outcome?
Buddy taping the small finger to the ring finger
Immobilization of the MCP in flexion and the PIP and DIP in extension with a custom splint
Open reduction internal fixation
PIP joint arthrodesis
HPI - 1 week old injury over finger Rt ring finger, treated by bone setter.
How would you treat this fracture-dislocation?
HPI - 10 days old injury left middle finger, treated with finger splint
Would you get a CT scan to determine proper treatment?