The following images represent classic signs and symptoms of Complex Regional Pain Syndrome, also known as CRPS. Historically, this has also been referred to as sympathetic reflex dystrophy or causalgia. I have found that the most sensitive and predictive finding is a dramatic loss in function (strength or motion) of a body part that is…
Mallet Finger CRPP – Franko
History: 31 year old female administrator injured her finger about 3 weeks prior to seeing me in the office. She had a fracture-dislocation of the finger tip, also known as a mallet finger or mallet fracture with dislocation. I recommend surgical treatment. To avoid making an incision, I recommended percutaneous pin treatment. Diagnosis: Right ring finger…
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…

Fingertip V-Y – Franko
History: 39 year-old female who amputated the tip of her left middle finger while doing her hobby of leather crafting. An emergency department cauterized the end of her finger to stop the bleeding and Dr. Franko saw her in the office for treatment. She had loss of the soft tissue with exposed distal phalanx. Diagnosis: Left long…

Thumb Amputation FDMA Flap – Franko
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…