Circular saw injury with complex laceration of left index finger with laceration of extensor tendon and joint capsule; laceration collateral ligament, radial side; compound fracture, base of the middle phalanx, articular involvement. Debridement and repair extensor tendon and joint capsule. Repair radial collateral ligament and wound closure. This is a year-old white male who accidentally injured his left index finger on a circular saw while working on broken shutters at home in his gargage.
The patient sustained a jagged laceration over the dorsal radial aspect of the index finger at the proximal interphalangeal joint. The wound was deep, involving the joint capsule, extensor tendon, and collateral lilgament. The bone was also involved, especially at the base of the middle phalanx into the apical surface.
The sensation to the tip of the finger was intact, especially all of the radial side. The wound measured about 3 cm in lenght. After anesthesia had been obtained, the hand was prepped and draped in the usual manner. Tourniquet then was placed at the base of the fingers.
The wound was then debrided. The minute loose bone and articular surface had to be removed. Some skin debrided was removed. After satisfactory debridement, the joint capsule and extensor tendon then were repaired with PDS sutre material. Teh radial collateral ligament also was repaired with the same suture material The skin then was carefully approximated with nylon.
After completion, a dressing was applied. An aluminum splint was placed. The patien received 1 g of Ancef in the emergency room. He will continue to take Keftab mg twice daily for 4 days and Vicodine 1 tablet q. The postoperative instructions were given.
Also the patient was informed about his injury and complications, especially wound infection and some stiffness of the finger. Thepatient will be followed up in my office. Outstanding Tutor who does excellent work.
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