This patient, a 34-year-old male whose pre and post-reduction x-rays are shown here (Figure 1 and Figure 2), presented to urgent care after sustaining an axial injury to his fourth left finger while playing a weekend game of football.
FIGURE 1. PRE-REDUCTION
Reduction proved physically chal- lenging to more than one practi- tioner. A physician who happened to be on site tried unsuccessfully to reduce the dislocation at the time it occurred, then recommended the patient seek urgent care.
FIGURE 2. POST-REDUCTION
Once the images had been evalu- ated, a digital block was applied and reduction was attempted by the urgent care physician. Again, the injury proved resistant to reduction.
The patient, a plumber by trade, suggested using a high-end pair of pliers from his toolbox—an offer declined by staff. Instead, after sev- eral more attempts, the physician donned surgical gloves in the hope of improving his grip. The increased friction afforded by the dry glove allowed sufficient traction to reduce the dislocation with relative ease.
Acknowledgment: Case presented by Drs. Nahum Kovalski and Brendan Stewart-Freedman of Terem Immediate Medical Care in Jerusalem. Dr. Steward-Freedman treat- ed the patient.
