PATHOLOGIC FINGER FRACTURE - BASKETBALL 1324

Abstract

HISTORY - A 13 year old, right hand dominant Asian male injured his right ring finger during a basketball game. The patient was going up for a rebound when his finger was grabbed by another player. The patient presented to the Emergency Department complaining of pain in the proximal phalanx and a decreased ability to move the right ring finger. After radiographs were taken, the patient was subsequently referred to our office for follow-up. PHYSICAL EXAMINATION - (2+) edema of the proximal phalanx was noted, neurovascular status was intact, moderate tenderness about the proximal phalanx, (-) rotational deformity noted, patient had limited flexion and extension secondary to pain, and no soft tissue lesions were noted. DIFFERENTIAL DIAGNOSIS: Fracture Proximal Phalanx Sprain/Strain Enchondroma Fibrous Dysplasia Chondroblastoma Unicameral Bone Cyst Chondrosarcoma Giant Cell Tumor TEST AND RESULTS: X-RAY - oblique fracture through the proximal phalanx with an expansile benign bone tumor Pathology - lobulated neoplastic cartilaginous tissue consistent with enchondroma FINAL DIAGNOSIS: Enchondroma, Proximal Phalanx TREATMENT: Splint × 3 Weeks Repeat X-Ray at weeks 1 and 3 Fracture healed at 6 weeks - however expansile lesion did not fill in as anticipated - surgery recommended 9 weeks post injury patient underwent curettage of proximal phalanx with iliac crest autograft Patient returned to full activity 6 months post surgery