History: 55 year old female had sustained a left wrist fracture 3 months prior to coming to my office. A different surgeon treated her with a cast for 6 weeks followed by brace. For the prior 2 months however she had progressive pain, swelling, and numbness/tingling in her wrist and fingers suggestive of carpal tunnel syndrome. …
Nail Bed Avulsion – Franko
History: 18 year old male injured his index finger after dropping a 60-pound weight at the gym. He presented to the emergency department for an open injury with an avulsed nail and nail bed laceration. Diagnosis: Right index finger open distal phalanx fracture with nail bed laceration and nail avulsion Treatment: Repair of nail bed and replacement of…
Mucous Cyst Bilobed Flap – Franko
History: 44 year old female with a chronic mass at her fingernail. The mass had been present for many months and would occasionally become infected and drain. It was also causing a depression in her nail and quite uncomfortable and unsightly. Diagnosis: Left ring finger mucous cyst Treatment: Mucous cyst excision with bilobed advancement flap Outcome: She healed the…
Finger Crush – Franko
History: 37 year old gentleman was in a motorcycle accident where he sustained a severe trauma and crush to his middle and ring fingers. I met him in the trauma bay where he had significant crushed finger tips and open wounds. Based on the amount of injury, I recommended revising the amputated digit tips to regain…
Dorsal Wrist Skin Graft – Franko
History: 61 year old female sustained an injury to her right wrist resulting in complete loss of skin over a large area measuring 10 x 6 cm. The existing skin had previously become infected and required debridement. I recommended a skin graft to provide coverage to the area. Diagnosis: Dorsal wrist large skin defect Treatment: Full thickness skin…
Bilateral Galeazzi ORIF – Franko
History: 21 year old male presented as a trauma patient after a motorcycle accident with injuries to his bilateral forearms. He was found to have a fracture radius on both side with a ligament injury at the wrist. He was initially splinted with recommendations for surgery. Diagnosis: Bilateral radial shaft (Galeazzi) fractures Treatment: Bilateral radial shaft ORIF Outcome: At…
Thumb Arthritis – Franko
History: 51 year old female with right thumb pain that had been present for over a year. Although it began after a fall, x-rays showed arthritis at the base of the thumb (CMC joint arthritis). After trying splinting, a steroid injection, and anti-inflammatory medication, she elected for surgery to alleviate her pain. Diagnosis: Right thumb CMC arthritis…
P1 Percutaneous Screws – Franko
History: 40 year-old male school principal came to my office after injuring his finger playing basketball and jamming the finger. He had significant pain and swelling and was unable to make a fist. X-rays showed a fracture of the proximal phalanx with displacement and rotation. Diagnosis: Left 5th proximal phalanx oblique fracture Treatment: Proximal phalanx closed reduction…
Clavicle ORIF – Franko
History: 23 year-old male who injured his shoulder and collar bone while trying to jump over a fence. He had sustained a comminuted, displaced clavicle fracture. Diagnosis: Left clavicle fracture Treatment: Left clavicle open reduction internal fixation Outcome: Within 1 week he had already regained nearly all motion without any pain. The photos below demonstrate his first post-operative visit….
Bennett CRPP – Franko
History: 28 year-old male injured his thumb in an automobile accident when the airbag deployed. He sustained a fracture of the thumb metacarpal base (Bennett fracture). Based on the best evidence available, he elected for percutaneous surgical treatment. Diagnosis: Right thumb Bennett fracture Treatment: Right thumb percutaneous pinning and cast Outcome: After completing the cast and having the…