Differential Diagnosis for Laceration to Left Second Digit

• Single most likely diagnosis
  • Digital nerve laceration or transection: The patient's report of numbness and stiffness in the second digit, followed by increased numbness and burning after attempting to move the finger, suggests damage to the digital nerves. The "pop" heard by the patient could indicate further injury to the nerve or surrounding tissues.
• Other Likely diagnoses
  • Tendon laceration or injury: The patient's attempt to move the finger resulted in a "pop," which could indicate a tendon injury, particularly if the Exaco knife cut deep enough to damage the tendons.
  • Vascular injury: The increased numbness and burning sensation could also suggest a vascular injury, such as a cut to an artery or vein, which would compromise blood flow to the digit.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Compartment syndrome: Although less likely, compartment syndrome is a serious condition that can occur after a laceration, especially if there is significant bleeding or swelling within a closed compartment. It is essential to monitor for signs of compartment syndrome, such as severe pain, pallor, poikilothermia, paresthesia, and pulselessness.
  • Infection (e.g., tetanus or gas gangrene): Any open wound, especially one caused by a dirty object like an Exaco knife, carries a risk of infection. While not immediately life-threatening, infections like tetanus or gas gangrene can become severe if not promptly treated.
• Rare diagnoses
  • Complex regional pain syndrome (CRPS): This condition is characterized by chronic pain, inflammation, and hypersensitivity after an injury. Although rare, CRPS could be considered if the patient's symptoms persist or worsen over time.
  • Neuroma formation: If the digital nerve is damaged, there is a small chance of neuroma formation, which can cause chronic pain, numbness, or tingling in the affected area.