mallet finger
TRANSCRIPT
无忧PPT整理发布
Orthopedics
Extern Case ConferenceNatthawut Nititanabhaworn
Patient profile หญิงไทย อายุ 54 ปี
Chief complaintรถจกัรยานยนต์ล้มทับนิ้วมอื
ซา้ย 2 ชัว่โมงก่อนมาโรงพยาบาล
Primary survey
A : can talk, no c-spine tendernessB : no dyspnea, RR 20C : no active external bleeding full pulse, BP 102/80D : E4V5M6E : laceration wound 3 cm at Lt. ring finger, deep to bone
Secondary survey
A : no drug/food allergyM : no medicationP : no underlying diseaseL : last meal 4 hrE : รถจกัรยานยนต์ท่ีจอดอยู่ ล้มทับนิ้วก้อยมอืซา้ย มแีผลเปิด ปวดมาก ขยบันิ้วก้อยได้ ไมช่าปลาย
น้ิว มเีลือดออกซมึๆ เหตเุกิด 2 hr
Diagnosis
Diagnosis
Open Mallet finger
“Extensor tendon injury”
“Mallet finger”
“Mallet finger”
Doyle's Classification of Mallet Finger Injuries
Type I • Closed injury with or without small dorsal avulusion fracture
Type II • Open injury (laceration)
Type III • Open injury (deep abrasion involving skin and tendon substance)
Type IV • Mallet fracture A = distal phalanx physeal injury (pediatrics)B = fracture fragment involving 20% to 50% of articular surface (adult)C = fracture fragment >50% of articular surface (adult)
Doyle's Classification of Mallet Finger Injuries
Type I • Closed injury with or without small dorsal avulusion fracture
Type II • Open injury (laceration)
Type III • Open injury (deep abrasion involving skin and tendon substance)
Type IV • Mallet fracture A = distal phalanx physeal injury (pediatrics)B = fracture fragment involving 20% to 50% of articular surface (adult)C = fracture fragment >50% of articular surface (adult)
Continuous splinting 8 wkSlightly hyperextension
Tendon repair& K-wire fixation
Doyle's Classification of Mallet Finger Injuries
Type I • Closed injury with or without small dorsal avulusion fracture
Type II • Open injury (laceration)
Type III • Open injury (deep abrasion involving skin and tendon substance)
Type IV • Mallet fracture A = distal phalanx physeal injury (pediatrics)B = fracture fragment involving 20% to 50% of articular surface (adult)C = fracture fragment >50% of articular surface (adult)
Continuous splinting 8 wkSlightly hyperextension
Tendon repair& K-wire fixation
Skin marceration/necrosis
“Swan neck deformities”
“Boutonniere deformities”
“Sagittal band rupture”
