P1 Derotation Osteotomy

History: 21 year-old female who fractured her left index finger in a car accident 2 years ago.  She was treated without surgery which resulted in the bone healing with a rotational deformity.  She notices that her index finger crosses over her other fingers when she makes a fist. 

Diagnosis: Left index proximal phalanx rotational malunion

Treatment: Left index finger proximal phalanx derotational osteotomy with locking blade plate

Outcome: After re-fracturing and fixing the bone in proper alignment, she no longer had “crossing over” of the index finger with flexion.  She worked hard with physical therapy and regained nearly all of her motion without any pain in the finger. 

Great motion and no pain about 4 months after surgery.  

Thumb Amp FDMA Flap

History: 25 year-old male injured his left thumb using a table saw resulting in an amputation of the thumb at the level of the interphalangeal joint. X-rays showed a partial thumb amputation.  He came to the emergency department with pain, disability, and bleeding. 

Diagnosis: Left thumb amputation at interphalangeal joint

Treatment: First dorsal metacarpal artery island flap

Outcome: He developed full healing and full use of his thumb within 2 months without difficulty.