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X-ray showing multiple fractures involving the shaft of the 4th metacarpal, basal intra articular fracture of the 5th metacarpal and open comminuted fracture of the proximal phalanx of the right little finger. ORIF is indicated in multiple fractures involving the hand. Note that the comminuted fracture of the shaft of the 4th metacarpal has been fixed with a bone tie and a neutralisation plate
