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.

Ganglion Cyst

Ms N is a 4 years old girl who had a fall on her palm two weeks ago was brought by her father showing a small pea-like swelling on the palmar surface of the proximal phalanx of her right little finger.

The swelling was only painful upon palpation. She otherwise had full function and power of her right little finger. It was difficult to tell whether she had the swelling previously as children do not usually complain until there is pain. I suggested an ultrasound of the swelling which should demonstrate a cystic (fluid-filled sac)swelling with some inflammation. I referred her to a Hand Orthopaedic Surgeon for further evaluation and treatment.

Ganglion cysts are the most common lesion of the hand and wrist, accounting for 50% to 70% of all masses identified. The majority of ganglion cysts can be treated nonoperatively but when surgery is performed a low recurrence rate can be anticipated. Giant cell tumor of the tendon sheath hand epidermoid cysts are also common hand lesions that require surgical excision in most instances. Of the three, giant cell tumor of tendon sheath have the most notable recurrence rates. (Nahra etal, 2004)

Usually Ganglion cysts may be treated non-surgically. If it becomes painful or restricts normal function, cyst aspiration and corticosteroid injection may help. Surgical excision usually has low recurrence rate.

Josiah fractures his clavicle?

Josiah Ng, who currently ranks 7th in the world suffered a hip contusion after hitting the training motor-pace bike on the 22nd March 2007. Just a week later he had a terrible mishap after an illegal technique used by an Italian rider caused him to loose control and crash. It was reported by the Star newspaper that he suffered a 'broken collar-bone.