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A 52-Year-Old Man With a Tuft Fracture and Hand Cellulitis
James McCallum1, Mary Kamienski
1James McCallum, MSN, BSN, RN, Staff RN, Robert Wood Johnson University Hospital Somerset Emergency Room, Somerville, NJ. Mary Kamienski, PhD, APRN, FAEN, FAAN, CEN, Director of Specialty Track FNP and FNP in Emergency Care, Rutgers College of Nursing Advanced Nursing Practice Division, Newark, NJ.
Abstract:
A 52-year-old man presented to the emergency department (ED) 1 week after getting his right index finger shut in a car door. The patient complained of right index finger pain. His entire hand was edematous and reddened. After evaluation in the ED and x-ray, the patient was diagnosed with a tuft fracture, right index finger/hand cellulitis, and possible osteomyelitis. The patient received tetanus diphtheria i.m., vancomycin 1 g i.v., and ceftriaxone (Rocephin) 2 g i.v. while in the ED and was admitted with referral to a hand specialist. The patient was discharged after 10 days of parental antibiotics. He has a history of sarcoidosis, hypertension, diabetes mellitus, and scleroderma. He is currently not taking any medications and denies allergies to medications and latex. The patient had no significant somatic findings. He was afebrile.
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