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Pediatric emergency medicine trisk 3340 3340

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FIGURE 109.1 Abnormal tenodesis. Clinical photographs depicting abnormal rotation of the
ring finger in the setting of a malrotated phalanx fracture. Note the clinical overlap of the ring
finger over the long finger and increased gap between the ring finger and the small finger, with
passive wrist extension (A ) that is not clinically as apparent with the wrist in neutral position
and the digits extended (B ). (Courtesy of Children’s Orthopaedic Surgery Foundation.)

Fingertip lacerations are managed similarly to lacerations in other locations
with a few caveats. Nearly circumferential wounds are common in pediatrics and
are managed as partial amputations. Some literature recommends nonabsorbable
suture material for the repair of these injuries, though we favor absorbable suture
because swelling and discomfort often preclude suture removal in children at the
time of follow-up.



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