Traumatic finger amputation

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Hand v circular saw.

Patient Data

Age: 35 years
Gender: Male
x-ray

Amputated finger (the fifth finger).

x-ray

There is extensive amputation and fractures of the second to fifth fingers:

  • The fifth finger is obliquely amputated through the proximal shaft of the proximal phalanx. The finger is absent, imaged separately showing no further fracture of the phalanges. The MCP joint is normal.
  • The fourth finger is transversely fractured through the base of the proximal phalanx and the finger is displaced in the volar direction and rotated towards the radius. I cannot exclude the fracture extending into the articular surface of the proximal phalanx.
  • The third finger MCP joint appears volarly dislocated, I cannot positively identify a fracture of the metacarpal head or proximal phalanx. The phalanges are intact.
  • The second finger is transversely fractured through the head of the second metacarpal, with the fracture off-ended and volarly displaced.
  • The thumb is intact.

No radiopaque foreign body identified.

Case Discussion

Evidently, the saw won. 

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