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Images in clinical practice
Delayed management of a ring finger injury by a thinned and tubed groin flap in a forward surgical unit
  1. Georges Pfister1,
  2. C Ranc2 and
  3. L Mathieu3
  1. 1 Department of Orthopedic, Trauma and Reconstructive Surgery, Hopital d'Instruction des Armees Percy, Clamart, France
  2. 2 Emergency Department, HIA Bégin, Saint Mandé, France
  3. 3 Department of Orthopaedic, Trauma and Reconstructive Surgery, HIA Percy, Clamart, France
  1. Correspondence to Georges Pfister, Hopital d'Instruction des Armees Percy, Clamart, France; georgespfister{at}hotmail.com

https://doi.org/10.1136/bmjmilitary-2022-002160

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    A 22-year-old, right-handed, Malian soldier was admitted for a ring finger avulsion injury of the right hand with a complete skin degloving of the fourth finger and a distal phalanx avulsion. The trauma occurred 6 days before while lifting a heavy box. Primary management was performed by a Malian military nurse and consisted in direct skin closure with dressing and splinting. At the admission, the skin over the middle and distal phalanges was necrosed. X-rays showed a transverse fracture of the distal phalange (Figure 1).

    Figure 1

    Photographs of the clinical aspect of the fourth digit when the patient presented at the Gao Role2 +MTF (Medical Treatment Facility) and profile radiograph of the fourth digit.

    The patient underwent a radical skin and soft tissue debridement. Regarding the high risk of infection, internal fixation of distal phalange was precluded, and a …

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    Footnotes

    • Contributors CR served as scientific advisor, LM critically reviewed the study proposal, GP provided and cared for study patients.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.