The following images demonstrate the temporary depigmentation and atrophy effects of Kenalog injected in the hand and wrist. The follow-up image is 6 months later.
Phalanx Fx x 3 with IM screws – Franko
History: 39 year old gentleman came to the office after a steel beam fell on his hand, crushing his index, middle, and ring fingers. He had fractures of the proximal phalanx to all three fingers and limited motion, swelling, and pain. Diagnosis: P1 fractures of index, middle, ring fingers Treatment: Index and Middle fingers intramedullary screw, Ring finger…
Table Saw Skin Graft – Franko
History: 63 year old gentleman sustained a table saw injury to his right index finger. This included a deep skin injury with full thickness loss but did not seem to involved the tendons, nerves, or vessels. Diagnosis: Right index full thickness loss Treatment: Full thickness skin graft to digit Outcome: Despite early loss of part of the graft, the…
PIP Joint ORIF – Franko
History: A 19 year old gentleman injured his middle finger joint while punching a wall. He presented to my office with an inability to flex and extend his middle finger and with pain and swelling. Diagnosis: Middle finger PIP joint intra-articular fracture with subluxation, moderately improved with traction Treatment: Middle phalanx open reduction, internal fixation with screws Outcome: He…
Deep Palm Infection – Franko
History: 71 year old female presented to the hospital about 2 weeks after a fall with increasing pain and swelling in her hand and palm. She had a history of psoriatic arthritis for which she took methotrexate and infliximab. Her presentation was very concerning for a deep infection with a WBC of 41,000, lactate of…
Flexor Tenosynovitis – Franko
History: A 55 year old female with diabetes presented to my office with severe pain and swelling in her middle finger a few days after burning the tip of her finger. This was initially treated with antibiotics for cellulitis however she rapidly progressed to flexor tenosynovitis based on the appearance and was taken to the operating…
Segmental Galeazzi ORIF – Franko
History: 24 year old gentleman presented to the hospital after crashing his motorcycle. He had obvious deformities to his right forearm and wrist. I evaluated him and recommended surgery for his complex radial shaft and DRUJ injuries. Intra-operatively he was found to have multiple shaft fractures, further complicating the surgery. Diagnosis: Right wrist and forearm Galeazzi fracture…
Open Galeazzi – Franko
History: 58 year old male was hit by a vehicle and presented to the hospital with obvious open deformities of his right forearm and wrist. He was diagnosed with an open radial shaft fracture and instability of the distal radioulnar joint. Diagnosis: Right open Galeazzi fracture Treatment: Open reduction, internal fixation of the radius with a combination of plates…