CASE
A 23-year-old man who was in good health slammed a car door on his left hand, crushing the fifth finger. Initial radiographic findings were negative for a fracture. Because of a small avulsion on the distal aspect of the finger, the patient was started on cephalexin (Keflex), and a foam finger splint was applied.
Four weeks later, the patient returned for a wound check. Examination revealed that the dermis on the distal aspect of the fifth finger had sloughed off. The underlying tissue was pink without pustular drainage or swelling, and granulation tissue was present. Range of motion at the distal interphalangeal joint was slightly decreased, and minimal pain was noted on palpation. The affected finger was neurovascularly intact. Vital signs were normal. The patient stated that the finger didn't
"really hurt much."
A radiograph was obtained (Figure 1). What is your impression?
