Concluded Case

hand injury

52 years, Non DM, right handed female with history of dog bite (pet dog) to left hand MF. It's Allen's type 3 fingertip injury. Pulp of finger is viable and non injured. Management options with respect to Rabies prophylaxis and injury repair.

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Concluded answer

Dog bite lt middle finger tip, injury Allen' s type 3 fingertip injury with viable pulp space Xray shows fracture tip of the terminal phalanx Wash the wound with running salon lotion Don' t go for tight complete repair with stitchs just afew stitches just to appose the margins As per history dog has not been immunised so inj ARV on day 0 4 7 14 28th day . Antibiotic broad spectrum Analgesic .

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Wound debridement and thorough wash Primary closure and k wire fixation of phalanx an option Inj TT Inj Tetglob Iv antibiotics including anaerobic coverage I am not an expert on Rabies My suggestion is full prophylaxis Observe the dog for two weeks: It could have been bitten by some stray animal. Unusual for normal pet dogs to inflict such an injury

Ok...understood...wouldn't k wire fixation further hamper the weak small tuft fracture? I mean cant only suturing of the nail bed suffice?
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Dog bite lt middle finger tip, injury Allen' s type 3 fingertip injury with viable pulp space Xray shows fracture tip of the terminal phalanx Wash the wound with running salon lotion Don' t go for tight complete repair with stitchs just afew stitches just to appose the margins As per history dog has not been immunised so inj ARV on day 0 4 7 14 28th day . Antibiotic broad spectrum Analgesic .

Thank you doctor
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