Hand Wound Monday: Open Mallet Fingers

Another case of the week:

Two gentlemen in their forties sustained dorsal tangential rotating saw blade injuries of their distal interphalangeal joints, fortunately not on the same night.

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Injury of the small finger, with loss of skin, terminal tendon insertion, and dorsal cortex of both sides of the joint. This shows the injury after debridement:

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A bit worse injury, involving the index and middle fingers of this insulin dependent diabetic. The index finger extensor tendon is simply divided, but the middle finger extensor tendon is absent from the mid-middle phalanx to its insertion – what is visible in this picture is periosteum. Additionally, both fingers have shredded and partially absent nail matrices.

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