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Volar plate avulsion fracture

Case contributed by Mohammad A. ElBeialy
Diagnosis certain

Presentation

Pain in the left 5th finger. Reported trauma while playing basketball and dislocation of the proximal interphalangeal joint with reduction by the patient himself.

Patient Data

Age: 25 years
Gender: Male
x-ray

Avulsion fracture of the volar plate of the proximal interphalangeal joint with avulsed bone fragment related to volar aspect of the base of the middle phalanx of the little finger.  No evident dislocation of the proximal interphalangeal joint is noted.

Annotated image

Volar plate avulsion injury of the base of the volar aspect of the middle phalanx of the little finger.   

Case Discussion

Volar plate avulsion injury of the base of the volar aspect of the middle phalanx of the little finger. The fracture was evident only in the lateral view of the little finger. Although one view is enough to diagnose a fracture if it is evident there, it is also insufficient to exclude a fracture. So, this case again illustrates one of the important rules in radiography that is "on view is one view too few"!   

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