Interpretation of Specialty Exams

Bloodwork:  All parameters of the hematology are normal.  Urinalysis results are reported as normal  too.  

Culture of the Fracture site:  Mixed culture of Stapylococcus aureus and Escherichia coli.  These bacteria were susceptible to second or third generation cephalosporins and amoxicillin/gentamycin combination.  

These results represent a local infection at the fracture site.  The bloodwork being normal is indicative of this.  

Radiographs:
Lateral:  There is a complete, oblique, closed fracture of the distal metacarpals 3 and 4.  There is considerable bony proliferation on the proximal side of the fracture.  This appears to be a callus, which implies that the bone is attempting to repair the damage.  The callus does not bridge the fracture.  It appears that the bony proliferation is beginning to grow distally in an attempt to bridge the fracture gap.  The two facing ends of the bone fragments do not appear to be properly aligned.  Thus, if the callus were to bridge the gap, it would form a mal-union.

Dorso-Palmar:  This further demonstrates the callus formation and the misalignment of the two pieces of bone.  With the superimposition of the two bones, the callus formation appears to bridge the fracture gap more than it does on the lateral view.  The fracture gap is the cause for the valgus deformity.  The distal fragment of metacarpals 3 and 4 is rotated so the distal end aims laterally.