Normal X-ray of the hand., comminuted fracture of the distal phalanx, Surgical Management Options, Post-Surgery & Further Care.

Findings in Image:

• Top Left: Normal X-ray of the hand.

• Bottom (AP & OBL views): Shows a comminuted fracture of the distal phalanx (finger tip bone) with loss of bone fragment – meaning it’s not just broken into multiple pieces but also missing part of the bone.

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Surgical Management Options:

Treatment depends on the extent of bone loss, soft tissue involvement, and finger function.

1. Debridement and Fixation

• First, the wound is cleaned to prevent infection.

• If bone fragments are salvageable, they may be fixed using K-wires (Kirschner wires) or mini plates/screws.

2. Bone Grafting

• If there’s significant bone loss, surgeons may take a bone graft (usually from the radius or iliac crest) to restore length and structure.

3. Soft Tissue Coverage

• Sometimes, skin flaps or grafts are required if there is an open injury with loss of soft tissue.

4. Amputation (last resort)

• If the bone loss is very severe with poor blood supply or infection risk, partial amputation of the fingertip may be necessary.

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Post-Surgery & Further Care:

• Immobilization: Splinting/casting for 4–6 weeks.

• Antibiotics & Pain Management: To prevent infection and manage pain.

• Physiotherapy: Early physiotherapy to maintain joint mobility and prevent stiffness.

• Long-term follow-up: To monitor healing, bone union, and finger function.