Recurrent Intentional Self-Inflicted Hand Injuries in a Soldier: A Case Report of Suspected Malingering and Multidisciplinary Management

Self-inflicted hand injuries in military personnel pose significant diagnostic challenges, often driven by behavioral or psychological motives. Early recognition of suspicious injury patterns is essential to ensure appropriate management and prevent reinforcement of maladaptive behaviors. A 23-year-old soldier presented with a displaced middle phalanx fracture and extensor tendon laceration of the left ring finger. Review of his medical record revealed three prior digital fractures over two years, each involving similar mechanisms and resulting in extended sick leave. The recurring nature, anatomical distribution, and preserved neurovascular function raised concern for intentional self-inflicted injury with suspected malingering motivated by secondary gain. Psychiatric evaluation revealed a stable clinical presentation but a history of substance-related issues and behavioral traits suggestive of secondary gain. A multidisciplinary plan was initiated, including structured psychiatric follow-up and coordination with military medical officers. Recurrent digital injuries in soldiers should prompt consideration of intentional self-inflicted injury and possible malingering, warranting multidisciplinary assessment. Multidisciplinary evaluation is critical for accurate diagnosis and effective management.