Methods (Differential diagnosis, investigations and treatment):
X-ray of the hand showed amputated first proximal phalanx with residual bone fragment at the base (figure 2). He was managed with IV amoxicillin/clavulanic acid and IM tetanus toxoid; for the pain a digital block was done and he was given ketorolac and paracetamol. The patient was admitted under plastic surgery’s service, and the surgery was performed 9 hours after the amputation.