History/Diagnosis: This patient sustained a very severe motorcycle accident with open injuries to the forearm, wrist, hand, and fingers. There were fractures of the ulna, radius, ulnar styloid, thumb dislocation, metacarpals, and CMC joints. I took her to the operative room for extensive surgery to repair and reconstruct all of the injuries. Treatment: Complex repair of all…
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…
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…
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…
4th/5th MC Dislocation – Franko
History: 20 year-old male punched a wall with his right fist and had immediate pain and swelling over the the dorsal and ulnar aspect of the hand and wrist. X-rays demonstrated a fracture of the hamate bone with the 4th and 5th metacarpal bones dislocated dorsally. Live flouroscopic imaging in the office demonstrated that they…
Metacarpal IM Screw – Franko
History: 30 year-old right-hand dominant male Sheriff impacted his left hand on concrete while wrestling a suspect. He had immediate pain and swelling over the base of the index finger. X-rays showed a metacarpal fracture with displacement and angulation resulting in severe pain, swelling, and deformity. Diagnosis: Left 2nd metacarpal fracture, displaced Treatment: Percutaneous reduction and internal fixation with an…
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…