This document summarizes a medical case involving a 41-year-old male butcher who cut off his right ring finger while slaughtering a cow. He presented to the emergency department with severe pain in his right ring finger after it was completely severed. Examination revealed a distal phalanx fracture of the right ring finger. The patient was admitted and underwent surgery to address his injury.

1. Orthopedics
Huzaifa Hamid Ahmad

2. Personal information:
Name: Sabah Muhammad Salh
Age: 41
Gender: male
Occupation: Butcher
Address: Sayd Sadq
Date of admission: 14/4/2015
Date of Examination: 14/4/2015

3. Chief complaint
Right ring finger pain for 3 hours duration

4. History of present illness
The condition started suddenly when the patient
was trying to slaughter a cow. He suddenly hit his
right ring finger distally with a knife, the finger was
cut off and separated completely. There was
bleeding at the site of the injury. the bleeding
was not severe because he pressed on it and
stopped the bleeding. There was severe
continues pain. Not radiating to any where, no
aggravating or relieving factor. He couldn’t
move his finger. There was mild degree of fever.

5. He came to emergency department and
admitted there. They cleaned the injury and
dressed it and then analgesics were given.
Investigations like X-Ray, CBC, viral markers and
ECG done, the doctor decided to do an urgent
surgery for him.
The X-Ray showed the distal phalanx fracture.
Other investigations were all normal.

6. Review of systems:
Gastrointestinal: -ve
Respiratory: -ve
Cardivascular: -ve
Genito-urinary: -ve
Central nervous system: -ve
Musculoskeletal: mentioned

7. Past medical history:
No DM, no HTN no asthma.
No previous admission.
Previous injury: no
Drug history:
No known drug allergies.
Not on any chronic medication.
Past surgical:
Negative.
No any blood transfusion.

8. Family history:
No HTN, No DM
Social history:
No passive smoker
Own house
Three family member
Tap water
animal contact

9. Examination:
Vital sign:
BP: 130/85
RR: 15
PR: 88
Temp: 37.3

10. Physical examination:
A young aged male sitting on his bed, conscious, alert,
cooperative, there was no dyspnea, no cyanosis, no pallor,
no jaundice, no palpable lymph nodes. No clubbing, no
bilateral pitting leg edema.
Look: no any congenital anomaly of the hands, no
swelling of the affected hand, no erythema. There was
dressing over the right ring finger no any bleeding.

11. Feel: No any temp. change, the right proximal ring
finger was tender, no crepitus, the pulses of the right and
left hand was palpable and normal, no tenderness of the
hands.
Move: Normal movement of the right hand, no any
limitation of movement apart from ring finger. On the left
hand, no any limitation of movement.

12. Neurological examination:
Normal tone, power, reflex of the upper limb, Normal
sensory.
Apart from ring finger which was tender and neurological
examination couldn’t be done.