![]() The size of the bone fragment does not necessarily correlate with the severity of the injury. “Trivial” chip fractures may represent avulsions of the ligaments and a significant soft tissue injury. Look closely for this, as it requires prompt surgical intervention. The bite mark may not be located near the metacarpophalangeal joint, but the injury may still have damaged the joint capsule. It must be noted during the physical examination.Ī punch against the face is at risk for a fight bite – a small wound that is replete with mouth flora (and subsequent infection). The key is that rotation cannot be determined by examining an x-ray. The nails should align in parallel, facing the ceiling fingertips should point to the scaphoid. Assessments of the patient’s hand rotation can be made by asking the patient to fold their hand half way into a fist.
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