Given an abstract, generate a keyword (a noun phrase) that best describes the focus or contribution of the paper. Such keywords can be directly from the given abstract or outside it.

Abstract: A complete volar dislocation of the metacarpophalangeal joint of a ring finger occurred in a 31-year-old man and was successfully treated by a closed reduction. We found only six cases of volar metacarpophalangeal joint dislocation reported in the literature all of which needed open reduction.
Adult

Abstract: A 16-year-old male presented with a hemopneumothorax following a gunshot wound to the left chest. He was treated effectively with closed suction drainage for 48 hours when he suddenly complained of severe left chest pain. Preoperative diagnosis was suggestive of a traumatic diaphragmatic hernia but operative findings were confirmatory of a rare hernia through the foramen of Bochdalek. Chest X-ray showing a gas-filled viscus above the diaphragm is diagnostic. Increased abdominal pressure generated when he was first hit by the bullet and aggravated by increased negative intrapleural pressure resulting from suction drainage of the hemothorax is the probable mechanism of the herniation.
Adolescence

Abstract: This article describes the circumstances of the diagnosis of three of a group of 12 high-functioning multiple personality disorder patients. All had performed major social and professional activities with consistent competence, and all appeared to be neurotic patients suitable for classical psychoanalysis. All 12 had been misdiagnosed on at least three occasions before the correct diagnosis was made. Aspects of the difficulties encountered in assessing these patients are discussed and guidelines for the preservation of their high level of function during the treatment process are offered.
Achievement