The ‘Shoelace Sign’: just another simple thumb laceration?

What is it about?

This article is important as avulsed digital nerve injuries (a type of injury where the nerve is torn out of the finger and commonly occurs when the finger is caught jumping from height) may be easily missed in the Emergency Department. Failure to take prompt action results in the avulsed nerve drying out and dying - making repair impossible. The correct emergency management is to tuck the exposed nerves back under the skin. This will help preserve them until they can be evaluated by a hand surgeon. If the exposed nerves have died, the only option left open to the surgeon is to use a nerve graft which is a much more complex procedure with a poorer outcome.

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