The patient is a 23-year-old healthy male presenting for a “wound check” about four weeks after crushing his left fifth finger in a car door. At that time, x-rays were negative for a fracture. He was placed on cephalexin because of a small avulsion of skin on the distal aspect of the finger.

Today, you find that the distal aspect of the dermis of the fifth finger has sloughed off. The underlying tissue is pink, without pustular drainage or swelling. Granulation tissue is present. There is decreased range of motion at the DIP joint and pain with palpation.

View the image taken and consider what your diagnosis and next steps would be.

23-year-old male has persistent wound after crushing finger
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