So working in a walk in ortho urgent care, I see all sorts of general orthopedic conditions. I never knew there were so many nursemaids elbows until I started it. You can imagine the LBP, the knee OA, the ankle sprains, etc. But every so often I get something I don't see very often. This is a Salter IV fracture of the middle phalanx. The kid was playing football and the ball impacted his finger awkwardly. Given the skeletal immaturity, will be treating this conservatively with a splint for a couple of weeks followed by buddy taping and early ROM.