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A 34-year-old male sustains the closed finger injury shown in Figure A one week ago. He undergoes closed reduction and pinning shown in Figure B to correct alignment. Which of the following is responsible for the apex palmar fracture deformity noted on the preoperative radiographs?
Indirect pull of the central slip on the distal fragment and the interossei insertions at the base of the proximal phalanx
Intrinsic muscle fibrosis and intrinsic minus contracture
PIP joint volar plate attenuation and extensor tendon disruption
Rupture of the central slip with attenuation of the triangular ligament and palmar migration of the lateral bands
Flexor tendon disruption with associated overpull of the extensor mechanism
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What is the optimal treatment for the proximal phalanx fracture shown in Figure A?
Open reduction and placement of two 0.045-inch K-wires placed longitudinally through the metacarpal head
Application of a 1.5-mm straight plate applied dorsally through and extensor tendon splitting approach
Open reduction and lag screw fixation with 1.3mm screws through a radial approach
Placement of a 1.5-mm condylar blade plate through a radial approach
Open reduction and retrograde passage of two 0.045-inch K-wires retrograde trough the PIP joint
HPI - Twisting injury to the hand
How would you manage this fracture?
HPI - 20 year old male presents with finger pain after a fall on outstretched hand. Closed injury. XRays are shown.
Is the current position of the fracture acceptable?
HPI - 1st surgery 3 Months ago open fracture middle phalanx index finger treated with a mini plate. It resulted in skin necrosis and non union.
2nd surgery reverse cross finger flap and K wire fixation.
How would you have treated this OPEN middle phalanx fracture on INITIAL presentation (see preoperative images above)?