DIP Joint Case

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DOI: 6/16/2016. Patient is a 53-year-old left hand dominant male employee who sustained injury when he got his right index finger caught in a meshing gear. Patient is status post right index finger exploration of open wound, debridement of skin, bone and subcutaneous tissue and distal interphalangeal distal interphalangeal (DIP) fusion on 6/22/16.
Based on the progress report dated 09/02/16, the damage was a little bit more significant than a mere laceration. There was absent bone of the right index finger middle phalanx at the DIP joint level. The blade had demolished the ulnar condyle of the middle phalanx at the DIP joint. Therefore, the DIP joint was deemed not to be salvageable. An arthrodesis of the right index finger DIP joint was attempted. He has had pins in place for two months, and have since been removed. However, he has since developed an ulnar deviation of …show more content…
There is mild-to-moderate tenderness. He has ulnar deviation at the DIP joint. The proximal interphalangeal (PIP) is stiff.

Range of motion at the DIP joint was minimal. Of note, radiographs of the right index finger, three views, were obtained on this visit and demonstrated an extremely comminuted and crumbling distal half of the middle phalanx. There is ulnar deviation of the distal phalanx where there has been failed fusion.
Assessment is status post right index finger attempted DIP arthrodesis 06/22/16.
MD indicated that this was a laceration and fracture of the right index finger middle phalanx. Unfortunately, it crouched upon the DIP joint. There was loss of bone stock with approximately 50% of the articular surface, but fusion was attempted as joint salvage was not possible.
With removal of the percutaneous hardware, the attempted fusion has fallen apart due to the severity of the comminution and lack of adequate bony stock. The patient desires to salvage the

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