PMC6374822_01
(a) Clinical aspect of the crush injury of the fourth finger. (b) X-rays showed a fracture dislocation of the proximal interphalangeal joint with third fragment.
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An examination revealed a crush injury of the fourth finger with tendons and bone exposed (Figure 1(a)). After this initial treatment, radiography revealed a fracture dislocation of the proximal interphalangeal joint of the fourth finger with a third fragment (Figure 1(b)), prompting the patient to undergo surgery.
(a) Clinical aspect after debridement and regularization at the level of traumatic amputation. (b) Coverage of the bone by the radial flap using separated stitches.
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Surgical exploration under locoregional anesthesia found that the ulnar digital pedicle was sectioned and thrombosed, the radial digital pedicle was intact, the flexor and extensor tendons were sectioned and shredded, and the skin was irreparably shredded (Figure 2(a)). Surgical procedures included removal of foreign bodies and excisional debridement of devitalized tissue, collection of bacteriological samples, copious irrigation with saline serum (3 liters), tendon striping, and finger amputation with coverage of the bone by the radial digital flap using separate stitches (Figure 2(b)).
(a, b) Clinical aspect at a follow-up of three months.
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At a three-month follow-up (Figures 3(a) and 3(b)), the patient showed no sign of infection; he returned to his usual activities and was discharged from care.