Carpenter Hammers His Distal Phalanx- Clinical Patient Case of the Week

Andrea Eberly, MD, MS, FAAEMClinical Pearls, Emergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Emergency Medicine, Pediatric Medicine, Personal Education, Physician Assistant, Urgent Care

Distal Phalanx Injury - Orthopedic Injuries of the Hand

Carpenter Hammers His Distal Phalanx - Clinical Patient Case of the Week

Try this free Orthopedic Injuries of the Hand Case Q&A courtesy of Med-Challenger.

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Try this case and test your knowledge of distal phalanx injuries.

A 36-year-old carpenter is working on a new home and is temporarily distracted. He misses a nail with his hammer and hits his distal phalanx, which was hanging over the end of a board. He presents to you after the event.

Your examination reveals erythema and swelling of the distal interphalangeal (DIP) joint. You obtain an x-ray (see Figure).

Distal Phalanx Injury - Orthopedic Injuries: Hand
The skin and nail are intact.

Question:

Which of the following statements is correct?

Answer Options:

The central extensor slip may be ruptured.

If it is not properly treated, this may result in a boutonniere deformity.

Optimal management is surgical.

This represents a zone 3 injury with possible concomitant flexor superficialis tendon injury.

See the Answer:

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