Presentation Lacerations arise from either a cut with a sharp object or direct blunt trauma that exceeds the tensile strength of the skin. Consequently, lacerations may be linear ( Fig. 140.1 ) or stellate/complex with various amounts of tissue loss.…
Presentation A sharp metal object, such as a needle, heavy wire, or nail, is driven into the soft tissue. The patient may arrive with an additional large object attached (e.g., a child who has stepped on a nail going through…
Presentation The patient complains of a paint chip or wooden sliver under the nail. Due to high sensory nerve density, these injuries are often quite painful. Most subungual foreign bodies are completely visible and are lodged under the distal portion…
Presentation The patient has been snagged with a fishhook and arrives with it embedded in the skin ( Fig. 137.1 ). This most commonly occurs on the hand, face, scalp, or upper extremity but can involve any body part. Removal…
Presentation A patient arrives holding a bandage over a missing fingertip. The patient may or may not have brought along the avulsed tissue. Traumatic finger pad injuries are common. The mechanisms of injury can be diverse: A knife, a meat…
Presentation Blunt trauma to the distal phalanx may result in nail avulsion, nail bed laceration, and distal phalanx fractures. The nail may be completely avulsed, partially held in place by the nail folds, or adhering only to the proximal nail…
Presentation The patient has experienced blunt trauma such as a fall or other impact injury. The initial pain has subsided, but point tenderness, swelling, ecchymosis, and pain with use remain after 3 days. On physical examination, there is insignificant loss…
Presentation A small child, riding on the back of a friend’s bicycle, gets their foot caught between the spinning spokes and the frame. The skin over the lateral and medial aspects of the foot or ankle is crushed and abraded…
Presentation The patient fell while holding on to a ski pole, banister, or other fixed object, forcing the thumb radially into abduction and causing pain at the base of the thumb. The metacarpophalangeal (MCP) joint of the thumb is swollen…
Presentation The patient, usually a young or middle-aged adult, complains of neck pain and is unable to turn the head, usually holding it twisted to one side, with involuntary spasm of the neck muscles and the chin pointing to the…