Metacarpal and digital injuries

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QUESTION 1 OF 3

An elderly patient caught the tip of his right middle finger in a circular saw as he was cutting wood. He presents to the ED with a 1cm defect in the skin of the tip of his pulp with no bone exposed. His x-rays show no associated bony injury
What is the most appropriate management for this patient?

QUESTION ID: 1253

1. Atasoy flap
2. Primary closure
3. Terminalisation to the distal interphalangeal joint level
4. Toilet, dressings and wound review 1 week
5. Venkataswami flap
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QUESTION 2 OF 3

After sustaining an axial load type injury to their right ring finger, a 22-year-old factory worker attends the hand trauma clinic with a painful proximal interphalangeal joint (PIPJ), and x-rays show a comminuted intra-articular fracture to the base of their middle phalanx and confirm a dorsal triangle sign.
What is the most appropriate management for this patient

QUESTION ID: 1255

1. Dynamic external fixation
2. Non-operative management with buddy taping
3. Open reduction and internal fixation
4. Splinting in flexion
5. Static external fixation
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QUESTION 3 OF 3

A 2 year old boy is brought to the trauma clinic having trapped his middle finger in a door. His mother is concerned about the fact he is unable to fully straighten his finger. His x-ray findings are shown below.
Involvement of which anatomical structure must be assumed with this x-ray appearance?

ER 2.png

QUESTION ID: 1258

1. Epiphysis of distal phalanx
2. Nail bed
3. Nail plate
4. Terminal extensor tendon
5. Triangular ligament
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