The most common etiology of the posterior variety of shoulder dislocation is a fall on an outstretched hand seizure automobile accident electrocution direct posterolateral blow to the shoulder 11. She complains of pain over the posterior elbow and an inability to extend it. X-rays were ordered and you see the findings depicted in this illustration. Tenderness over the anatomic snuff box with negative X-rays needs radial gutter splint thumb spica splint short arm splint long arm splint reassurance only 24. The carpal tunnel DOES NOT contain flexor digitorum superficialis flexor digitorum profundus flexor pollicus longus palmaris longus median nerve 25.
Physical exam reveals tenderness over the dorsum of the middle phalanx of the long finger.
Radiographs are normal. All collateral ligaments are stable on testing, and nontender. On hyperextension of the finger there is no pain, tenderness, or instability. Correct initial treatment is Buddy taping of the middle and index fingers Ice, elevation, then active motion as tolerated in 24 hours Short arm cast with metal outrigger to hold the metacarpophalangeal joint in flexion and the interphalangeal joints in extension Splinting the proximal interphalangeal joint in extension, using a posterior splint Offer reassurnace and discharge 31. The right leg is shortened, internally rotated, and adducted.