Ortho Hors D'oeuvres (Prompt):

Patient is a 26 year-old right-handed male presenting with right hand pain. Right small finger was hit with basketball immediately prior to presentation. Finger was in flexed position, which improved when one of his friends "pulled on his finger." Patient now has minimal pain in the affected digit but has difficulty with movement in some of the joints. In particular, he cannot actively extend at the proximal interphalangeal joint. He is otherwise neurovascularly intact.

Radiographs are below:

Questions:

1) What is the suspected injury by history and radiographs? 2) What are the confirmatory tests to perform as part of the physical exam?

3) What is the appropriate management for this injury? How would this change if the patient had associated fractures?


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