David Nelson , MD Private Practice, San Francisco Webmaster, eRadius Associate Editor, J Hand Surgery Director, San Francisco Bay Area Hand Club

The patient did not want to have a followup appointment in one week, because she was afraid of missing work. She accepted a followup appointment for October 11. She failed to keep that appointment, so we called her. She told me that she overslept, yet was in so much pain that she felt that she should go the the emergency room. We convinced her to come to the office. She stated she would come in "right away." A few hours later, she came to the office, still complaining of severe pain. She admitted to drinking at the time of her original injury and since the first office visit. She also mentioned that she had fallen at least once on her hand, while drinking on a sailboat. These xrays were obtained.

(3) What is your reading of the xrays and what would your recommendation be?

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