About 3 weeks ago, a Ugandan friend of mine (aged 25) broke the bone leading from the knuckle of his right index finger to the wrist as a result of a punch he threw. A local doctor tried to reset the bone and put a cast on extending from just above the knuckles to just above the wrist. A few days ago my friend was probing the area under the cast and could feel a pronounced bump at the site of the fracture. He went back to the doctor for an xray (attached). The xray doesn't seem to suggest the bone was reset properly or that any healing has taken place. The doctor told us that callus would form in a circular fashion around the break and eventually the bone would straighten out and become more or less normal. He suggested leaving the cast on for another week and then switching to a wrist brace for another 2-3 weeks after that.
It just seems that the bone is not aligned properly and might need to be reset. Any advice would be much appreciated.
Well, without knowing the relevant clinical details or having a look at the x-rays, it would be difficult to comment specifically on the situation. Though perfect alignment may not be required for healing, the two ends would require atleast gross alignment for callus formation and healing to take place. If there is no evidence at all of callus formation in 3 weeks, mal-alignment is a likely possibility. If in doubt, you may consider seeking a second opinion with another orthopedician for a review.
Hope this is helpful.
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