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Open Dislocation of Fifth Digit

Robert Rowe, MD^* and Alisa Wray, MD^*

DOI: https://doi.org/10.21980/J8J01XIssue 1:2 No ratings yet.

Physical exam revealed an open dislocation of the proximal interphalangeal joint (PIP) of the right fifth digit. X-ray confirmed dislocation and revealed no fractures. The patient received a tetanus booster, Cefazolin, and the dislocation was then washed out and reduced. Multiple reduction attempts were made and were only successful once the metacarpophalangeal joints were held in 90 degree flexion, which relaxed the lateral bands and enabled the finger to be reduced.

Orthopedics Visual EM

Morel-Lavallée Lesion

Grant G Simpson* and Brandon R Allen, MD^*

DOI: https://doi.org/10.21980/J88G65Issue 1:2 No ratings yet.

On physical examination, the patient was noted to have a nearly “watermelon-sized” fluctuant mass to his right lateral superior quadriceps with multiple overlying abrasions (Image 1). Computed tomography (CT) scans of the area showed a large heterogeneous collection measuring roughly 37x9.5x16 centimeters in the subcutaneous adipose layer of the lateral right thigh (Image 2), while ultrasonography revealed a complex fluid collection containing some nodular solid components and debris (Image 3). Additionally, radiographs confirmed multiple fractures including most significantly a pelvic ring fracture. Surgical debridement, evacuation, and sclerodhesis were performed nine weeks post injury to allow overlying abrasions to heal prior to intervention.

Orthopedics Visual EM