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Monday, 23 June 2008

Finger fracture with long extensor tendon rupture


A gentleman came in this morning clutching his wrist with a profusely bleeding left middle finger. His finger was hit by a falling panel which dislodged his wedding ring and cut his finger while deforming it instantly.

The left middle finger had a swan neck deformity and a gaping laceration across the middle phalanx oozing out with blood. There was crepitus (indicating a fracture) and he could not extend his distal phalanx suggesting a ruptured long extensor tendon.


I quickly cleaned his wound with Povidone iodine, applied a pressure bandage to stop bleeding, did a buddy taping with a finger splint running across the hand on both sides. He was referred to an Orthopaedic surgeon for further evaluation and treatment. If he was an athlete who had to use his upper limb, he should be out of training for at least 4 weeks.

Lateral Ligament Complex Sprain: Anterior Drawer's Test

video

Wednesday, 18 June 2008

Toe abrasions from cycling without proper footwear



I took these 2 photos of the right forefoot of a young cyclist who decided to ride to a grocery shop in slippers instead of cycling shoes. It would be prudent for cyclists to wear suitable footwear even if they are making short trips as abrasions like these are quite common otherwise.

Tuesday, 17 June 2008

Foot contusion from soccer


A recreational soccer player came to me showing off his bruised left foot 2 weeks ago. He told me he was kicked by an opponent and had difficulty sprinting fully although he was a forward.

I examined him and found that he only had slight difficulty toeing-off while running and was able to do resisted ankle dorsiflexion. Besides the RICE treatment, he was given an anti-inflammatory gel e.g. Reparil and 5 days of Cox-2 selective NSAIDS as he has previous history of gastric pain. He was advised him to avoid full sprints and jumps for the next week. If he was to play, he needs to tape his ankle and foot to avoid the full plantarflexion (to allow pain-free range of motion). I expect him to be better within 1 to 2 weeks.