Right Finger Case Summary

DOI: 8/18/2016. Patient is a year old right hand dominant male manager who sustained injury while he was pushing around a cart when his finger got smashed between a metal cart and beam. Per OMNI, he was initially diagnosed with fracture of the right ring finger. He is status post nail bed and fracture fixation on 08/30/15.

Based on the medical report dated 08/22/16 by Dr. Donnelly, the patient continues to complain of pain to the finger, rated as 5/10. He is still working, wearing a splint over the finger.
On examination of the right upper extremity, the right hand has marked swelling to the ring finger. There is disruption of the end of the nail plate with injury to the nail bed. He has tenderness to palpation with decreased light touch sensation to the tip of his finger. He has intact flexion to the interphalangeal joints and intact extension.
Current medications include ibuprofen and Keflex.

Impression includes right ring finger crush injury with open distal phalanx fracture and right ring finger nail bed laceration
Given the displacement of the fracture and the nail bed injury, recommend was made for surgical fixation, irrigation and debridement of the open fracture, repair of the open fracture with possible pinning as well as repair of the nail bed. He would like to proceed. In the meantime he will continue the immobilizer brace and