Today was an interesting day to see the least. As soon as I arrived to the clinic, Jeanie informed me of a case coming in from the ER. A man had literally smashed his thumb as he was handling heavy steel objects in his shop this morning. As Dr. Williams removed the dressing on the wound, blood immediately began gushing. A fragment of bone was completely displaced at the tip of his thumb. The patient’s nail was also detached. Dr. Williams felt that the procedure can be done in the clinic. All the necessary equipment and instruments were available for the procedure to be carried out. To eliminate the possibility of infection, sterile conditions were maintained. Dr. Williams was cautious in disinfecting everything and cleaning out the wound before proceeding. Fortunately for the patient he still retained feeling in the tip of his thumb; otherwise part of it would have been removed. However, the patient’s Nail bed (soft tissue below the nail which keeps nail intact with the finger) has been injured. Dr. Williams noted that the patient’s nail would grow back crooked.
The patient’s thumb was numbed first, then his nail was removed and thoroughly rinsed. Dr. Williams then removed detached tissue and the bone fragment which was underneath the nail. Sutures were used to bring pieces of the finger back in place. After closing the wound, Dr. Williams trimmed the finger nail he removed and placed it back in the Nail bed. New dressing was applied and the procedure was essentially over.
This procedure lasted about 15 minutes, and set Dr. Williams back in his schedule. Although this is nowhere near the magnitude or caliber of procedures orthopedists performs, it was my first exposure to anything of this nature. I found it fun to watch such a minor procedure, yet I still long to witness a real surgery. As of now I’m content, but wouldn’t mind seeing more of these cases come by.
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