This patient survived a gas explosion injury with severe multitrauma and thermal burns to bilateral upper extremities including an open displaced comminuted fracture of the proximal phalanx of the right middle finger with some bone loss and disruption of the extensor digitorum communis tendon, an open displaced markedly comminuted intra-articular fracture of the distal metacarpal of the right index finger with bone loss and complete disruption of the extensor digitorum communis and extensor indicis proprius tendons, an open fracture of the ulnar articular surface of the metacarpal head of the right thumb with disruption of joint capsule and ulnar collateral ligament, the first dorsal interosseous and the superficial head of the adductor pollicis muscle and extensor pollicis longus tendon. Additionally, there was an open wound of the right proximal volar forearm with partial disruption of the flexor muscle bellies.
