ORTHOPAEDY AND TRAUMATOLOGY DEPARTMENT

MEDICAL FACULTY
HASANUDDIN UNIVERSITY

FINGER TIP INJURY

PREPARED BY:
Nor Hazirah Binti Omar
C 111 09 846
ADVISOR:
dr. Alfa Januar
dr. Satria Prawira Putra
CONSULTANT:
dr. Muhammad Sakti, Sp.OT
PRESENTED AS CLINICAL ASSIGNMENT
IN ORTHOPAEDY AND TRAUMATOLOGY DEPARTMENT
MEDICAL FACULTY OF HASANUDDIN UNIVERSITY
MAKASSAR
2014

CASE REPORT & REFERAT

FEBRUARI 2015

IDENTITY
Name

: S

Age

: 51 years old / Male

Admission : January 26th, 2015 at 18:00

Registratio : 69 87 31
n
Status

: BPJS

AUTOANAMNESIS
(at 18:02)

Chief Complain : Pain at right hand

Suffered since 1 day before admitted to

Wahidin General Hospital.
Patient was turning on a tractor machine
when his right hand accidentally get sliced
by the flywheel of the engine.
Patient is a farmer and right hand
dominant
Prior treatment at Jeneponto Hospital.

GENERAL STATUS
(at 18: 04)

Conscious / well-nourished
Vital Signs:
Blood pressure
: 120/70 mmHg
Pulse rate
: 88 x/min
Respiratory rate
: 18 x/min
Temperature
: 36.70C
NRS : 3

LOCAL STATUS
Right hand Region

(at 18:06)

Look

: Stitched wound at middle finger, posterior side at the level

of middle phalanx, 1,5 cm in length
Stitched wound at ring finger, semicircular at the level of DIP
joint, 3 cm in length
Lacerated wound at ring finger, longitudinal, posterior side,
1cm
Traumatic amputation at the level of distal phalanx little
finger, bone exposed

Feel

: Tenderness (+)
NVD: Sensibility is hypoesthesia at ring finger, normal at
middle finger CRT < 2 sec.

Move

: Active and passive movements of

Active and passive movements of
normal
Active and passive movements of
finger and little finger are normal
Active and passive movements of
are normal

wrist joint are normal

MCP,IP joint of thumb are
MCP,PIP,DIP joint of index
MCP, PIP joint of middle

CLINICAL FINDINGS

CLINICAL FINDINGS

RADIOLOGY FINDINGS
(18.30)

RADIOLOGY FINDINGS
(18.30)

LABORATORY FINDINGS
(at 18.40)

WBC : 12.500/ul
RBC : 4.530.000/ul
HBG : 14 g/dl
HCT : 44 %
PLT
: 278.000/mm3
CT
: 800
BT
: 300
HBsAg : Non-reactive

PREOPERATIVE
DIAGNOSIS

Lacerated Wound at right middle and

ring finger
Finger Tip Injury right little finger
Allen Type III
Susp.Rupture right 3rd and 4th
Extensor digitorum communis tendon
Susp. Open dislocation DIP joint right
ring finger

MANAGEMENT

Ringer Lactat Infusion

Analgesic
Antibiotic
Antitetanus
Report to Orthopaedic senior, advice:
Debridement + Repair Tendon
Apply K-Wire

OPERATION REPORT
1. Patient in supine position by general anestesia
2. Disinfection and drapping procedure
3. Identification : Traumatic amputation right
distal phalanx 5th finger, total rupture extensor
digitorum tendon right 3rd finger, total rupture
extensor digitorum tendon 4th finger, Open
dislocation right DIP joint 4th finger, lacerated
wound right middle phalanx 4th finger.
4. Rinse the wound with NACl 0,9% 2L

7. Apply K-wire 1.2 mm at 4th finger

8. Performed tendon repair tendon of extensor
digitorum communis tendon 3rd and 4th finger with
UNHAS Suture technique using non-absorbable 3.0
suture
8. The irrigation was done with Na Cl 0,9 % and
debridement until the wound looked clean
9. The wound approximation was done
10. The wound was closed with tulle and steril dressing
11. Applying volar slab below elbow at right upper limb
12. Operation was done

POSTOPERATIVE
DIAGNOSIS

Finger Tip Injury right little finger Allen

Type III
Total Rupture Extensor digitorum tendon
right 3rd finger zone II
Total rupture extensor digitorum tendon
right 4th finger zone I
Open dislocation right DIP joint of ring
finger
Lacerated Wound ring finger