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PROCEDURE: A longitudinal incision was made on the dorsum of the right finger through skin and subcutaneous tissue. Full flaps were elevated. The extensor tendons were visualized and the fracture was visualized distal to the central slip insertion. The fracture was mobilized and was noted to be comminuted and approximately free of fragments. This was not amenable to K-wire fixation. Therefore, it decided to use sutures to hold the fracture in place. The PIP joint was noted to be dislocated volarly and it was decided to use an external fixator to fix this. Using 0.045 K-wires, three K-wires were placed transversely across the finger, first in the head of the proximal phalanx and 2 more distally in the shaft of the middle phalanx. Position of the K-wires were noted to be good. The K-wires were then bent to give some dynamic dorsal pressure to the middle phalanx and this allowed the joint to be reduced nicely. The joint was reduced nicely and it was felt that the rubber band fixation would not be necessary for this. Following this, the K-wires were bent and cut and pin caps were applied.
jdemar, CPC, CMA