Aaron Mull & Amy M. MooreA 28-year-old left hand-dominant man presents with hand pain after striking someone with his left hand. The X-ray is shown above. On examination, overlapping of the patient′s ring and small fingers is noted while he makes a fist.
Description
Oblique extra-articular fracture of ring finger metacarpal shaft with angulation, rotation, and shortening,
Work-up
History
Mechanism of injury (e.g., sharp, blunt, avulsion).
Time elapsed since injury.
Possible contamination during injury (e.g., oral contamination, farm injury).
Hand dominance.
Occupation.
Smoking status.
Inquire about prior hand injuries or operations.
Physical examination
Assess for skin lacerations/injury, degree of contamination, and viability of soft tissues.
Examine for possibility of open fractures and joint involvement.
Assess for angulation and rotation of digit while the patient makes a fist (i.e., scissoring).
Assess for neurovascular integrity of the affected digits.
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