24 years old male got injured when a slab fell on his hand during work. He presented with partial amputation of middle finger and ring finger.
There was a big lacerated wound palmar aspects of both the fingers.
The circulation in the partially amputated parts was doubtful.
The patient was immediately taken to operation theater after xray.
The xray revealed following picture.
Third ray (Middle finger) showed fractures in distal and middle phalanx, around the distal interphalangeal joint ( the joint between two phalanges).
These fractures have been marked by arrows. The partial ampuation was at distal fracture level.
There was also a fracture of tip of distal phalanx in fourth ray (ring finger). It is not very clear on this xray but a shadow is visible between two arrows.
The fractures were reduced and fixed with Kirschner wires and circulation was rechecked. It showed an improvement and eventually the parts survived.
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