By Tedler D. Depaynos, MD
It was nearly dawn and the morning lights were about to end the night when the male patient was brought to the emergency room (ER). Despite his strong San Miguel breath, he was obviously in pain. He came accompanied by his wife with his left hand raised and covered with white bloodied cloth.
They just celebrated a birthday of a co-employee with over flowing alcoholic bottles and “pulotan” with the Sagada Lunch specialty when they all departed just about midnight. He was with his service motorcycle rushing home and when he tried to overtake a heavily loaded SUV, the left handle of his bike hit the side of an incoming truck. It was good that he was not thrown around and probably the truck driver did not even notice that they collided because the truck proceeded with its slow pace and did not stop. He suddenly lost his elated feeling and slight dizziness and knowing that it was his fault, he just proceeded home.
His fifth finger was literally crushed and the tiny bones were exposed and protruding out. Luckily, it was only the soft tissues that were severely damaged and the finger bones were just dislocated as confirmed by x-rays. It was classically an open fracture.
When bones in these cases are exposed, the danger of bone infection called osteomyelitis is great. Compared to soft tissue infections, it is difficult to treat and antibiotic intake would take a longer time. Hence, prevention is a must!
Under adequate anesthesia, the crushed finger was cleansed thoroughly and meticulously repaired after the dislocated finger bones were properly set. Although the blood supply appeared to be adequate the danger of amputation was explained to the patient in case gangrene unfortunately occurs especially if infection sets in despite the massive antibiotics. With a wide smile the attending MD advised the patient that anyway he still would have four functioning fingers and still would be able to wheeze with his service motorcycle without inhibitions.
It was a very painful lesson however to the patient and he not only promised himself but warned others not to drive a motor vehicle especially a motorcycle when tipsy. He was very thankful that his injury appeared minor for he realized that he could have even lost his life! Actually he silently shed tears when his wife was holding his hand at the ER while carrying their baby.**
