Aaron is a 50-year-old builder who presents after dropping a marble benchtop on the tip of his right middle finger. 

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<p>Aaron is a 50-year-old builder who presents after dropping a marble benchtop on the tip of his right middle finger. He reports that the finger swelled, "hurt like crazy and looked wrong" immediately after the injury.</p><p>Aaron is generally well, with well-controlled hypertension on candesartan. He has no other past history of note.</p><p>On examination, the affected distal interphalangeal joint is in a flexed position (pictured), with full passive extension but limited active extension. There is a subungual haematoma but no obvious nail bed injury.</p>

Dr Ash Chehata is an orthopaedic surgeon, specialising in upper limb surgery, based in Melbourne, Victoria.