The Faculty "axe"ident - Page #1
 

Author: Scotty Newcomer, DO
Co Author #1: Jessica Stumbo, MD
Co Author #2: Jennifer Daily, MD
Editor: Marc Hilgers, MD, PhD, FAMSSM
Senior Editor: Marc Hilgers, MD, PhD, FAMSSM

Patient Presentation:
A 41 yo right hand dominant female presented after a faculty development retreat at the local Axe throwing establishment for right hand pain.

History:
The patient reports she was throwing an axe over her head and felt a snap in her right middle finger followed by immediate pain and swelling. She attempted to throw another axe, but felt a more severe snapping pain with associated deformity and increased swelling.
She was previously a pugilist(boxer), but had not boxed in the past 8-10 years. The patient denied any previous hand injury.

Physical Exam:
Musculoskeletal
Right wrist:
non-tender, full range of motion
Right hand:
Swelling and erythema were present in the long finger over the dorsal MCP Case Photo #1 .
She was tender at the dorsal long finger MCP joint, including the radial and ulnar aspects of the joint.
Full long finger ROM in extension with pain, limited ROM in flexion of 3rd finger due to recurrent snapping.

Vascular: Pulses 2+ full and equal, cap refill <2 sec.

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