Family Practice Physician removing bone in outpatient setting HELP!!!

mray2011

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Demopolis, AL
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HELP!! My Physician NEVER does things like this and I am at a LOSS!!!!

Pre op DX: 41-year old male with a router injury with laceration of second and third finger and also crushed injury to distal third finger.



Procedure: X-RAY was done to show second finger with fracture pathology at base of middle phalanx of the second finger with large bone chip in the dorsal soft tissue opposite of the second finger and bone chip in the proximal interphalangeal joint. Both fingers with multiple fractures as more of the distal portion of middle phalanx and the third finger as well as multiple fracture of distal phalanx of third finger. The area was sterilely prepped and draped with betadine and the area was explored. Multiple bone chips were removed from the distal third finger. And the bleesing was slowed down with tourniquet. The laceration is about 3 inches in length with multiple irregular shape and they were sewn up with 3-0 and 4-0 probing. Bleeding was then stopped and then becuase the bone chips were removed we used a little hub to cover over the fracture on the middle part of the middle finger. A total of 12 stitches were used. We then proceeded with the INDEX finger. A piece of the bone was hanging loose from the middle. interphalangeal area and was removed patient had good pulses and before the suturing was able to remove but with tremendous amount of pain in both fingers. The bleeding was profuse, therefore we had to use interrupted sutures of 3-0 vicryl on the inside to stop the bleeding and on the outside we used 2-0 and 3-0 prolene interrupted stitches of the length of 3 inches. The bleeding was stiooed and the tourniquet was removed. total of 12 stithces on the second finger also. Patients pain control was with demerol and phenergan. All the bleeding has stopped and the patient tolerated well. Patient will be admitted for observation.
 
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