Hand Injury—football

Abstract

CASE HISTORY: The patient is a 17 y/o right hand dominant high school linebacker who sustained a traumatic right hand 3rd metacarpal injury during a football game. The patient sustained the injury while tackling the ball carrier on the opposing team. During the tackle he sustained blunt trauma to the dorsal surface of his hand. The athletic trainer was called onto the field immediately after the injury and after initial evaluation transferred the patient to the emergency department for emergent evaluation. PHYSICAL EXAMINATION FINDING: Open traumatic wound of the 3rd MCP joint, with head of metacarpal bone extending out of palmar aspect of right hand Finger neurovascularly intact DIFFERENTIAL DIAGNOSIS: 3rd Metacarpal open fracture Metcarpophalangeal joint dislocation TEST AND RESULTS: X-ray: Complete Dorsal Ulnar Dislocation at the long finger MCP joint with several tiny ossific fracture fragments and soft tissue swelling FINAL/WORKING DIAGNOSIS: Right hand 3rd open MCP joint dislocation TREATMENT: Patient underwent intraoperative reduction of 3rd MCP joint Postoperative antibiotic prophylaxis with Augmentin OUTCOME: Patient had good wound healing on follow up 1 week later No residual deficits in functional use of right hand RETURN TO ACTIVITY AND FOLLOW-UP: He returned to play 4 weeks from his injury