Pinky Finger Crush Injury Report

His dressings are removed along with the brace and his incision is a curvilinear laceration through the medial retinacular region. Extensor mechanism of the knee is intact and a straight leg raise is painful but normal. Range of motion is grossly limited in flexion secondary to pain but full extension is easily achieved. He is stable with varus and valgus stress testing at 0 and 30 degrees. Gentle Lachman's test does not demonstrate any gross instability. The ankle shows some dependent edema but no acute injury. Range of motion, dorsiflexion, plantar flexion, inversion, and eversion are all intact with adequate strength. Extensor hallucis longus, dorsiflexion, plantar flexion function of the ankle are all intact with 5/5 strength, L3-S1 sensory dermatomes are intact to light touch, though the patient does describe some mild periwound numbness. There is no streaking erythema. Wound is benign and shows no signs or symptoms of infection. Vascular tone is full and compartments are

S: TM works in GA Final when she closed the Sante Fe’s back door on her left pointer finger. TM rates her pain at 10/10 pulsating type pain. After 20 minutes of ice TM rates her pain at 7/10. TM reports initial bleeding, copious amount from her left pointer finger distal phalanx. TM denies previous injury to the location.

Patient is a 57-year-old male fuel tank driver who sustained cumulative trauma on 2/7/2004 due to repetitive movement caused by delivering fuel. As per QME dated 1/25/14, the patient has numbness in the fingers and the patient is diagnoses that he has carpal tunnel syndrome. The left wrist had undergone carpal tunnel surgery; however, he gets numbness from the wrist up into his forearm and numbness in the fingertips. It was also noted that on 12/5/13, the patient complains of shoulder pain bilaterally at 7/10. It is constant and goes into noth arms, along with weakness with numbness in the hands, decreased ability to perform activities of daily living, and impared grip. The pain in the bilateral shoulders is constant and aching with intermittent

Temp 97.5, blood pressure 123/83, O2 sat 95% on room air, pulse 81. Alert male, no acute distress. Pleasant and cooperative. Pupils equal, round, react to light. Examination of the scalp reveals laceration on the posterior scalp. Wound edges well approximated

O: Inspection of the right shoulder, no redness or edema noted; palpation of the right shoulder there was no warmth noted; on deep palpation TM reports in some tenderness

O:Left Wrist: no edema, no discoloration, full ROM, no impairment of the NVS, radial and ulnar pulses +3, pea-sized bump palpated in the dorsal radial border that is firm and stationed and causes pain with pushing on it or extension of the wrist.

In order to properly diagnose this type of injury, Dr. Erik Nilssen and his medical staff take several things into consideration, including the patient’s:

Based on the progress report dated 02/29/16 by Dr. Naraghi, the patient reports worsening of her right lower extremity with pain, numbness and weakness.

DIAGNOSIS: Strain of muscle, fascia, and tendon at neck level; Carpal tunnel syndrome, unspecified right limb,;Carpal tunnel syndrome, unspecified left limb; Status post left carpal tunnel release; and Adhesive capsulitis of right shoulder (M75.01).

DOI: 3/12/2013. Patient is a 57-year-old male service technician who sustained injury when he slipped and fell in mud while delivering a propane gas. Per OMNI, he is status post right knee surgery on 05/12/14.

HISTORY OF PRESENT ILLNESS: This patient is a 40-year-old male. Industrial injury, he got his finger caught in something at work. He sustained an open fracture, distal phalanx of the left small finger. He was seen in the ER. The finger was sutured in the ER. He presents for followup here.

PHYSICAL EXAM: Examination shows comparing the right hand to the left, including the hand and wrist region, that there are skin scratches, very superficial, from activity. There is no tenderness. There is no soft tissue swelling. There is normal alignment. No deep tenderness to palpation over the fractures. No crepitus. No instability. Active range of motion is about 85% of the contralateral left side.

O: On inspection, no edema or discoloration noted (patient was on ice for 10 minutes already at that time) Full ROM, reports severe pain (10/10) with overhead reach; Increased pain with Hawkins' Impingement

Based on the medical report dated 03/30/16, the patient has had pain in the right lower leg, numbness and tingling on the left side as well, rated as 8-9/10.

PHYSICAL EXAM: Wounds are healed. Calves are soft, nontender, nondistended. No pitting edema. Motion of the hip causes no pain.