Pediatric Gamekeeper's thumb

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- Discussion: - usually involves an SH type III avulsion fracture of thrumb proximal phalanx; - Radiographs: - unlike adult gamekeeper's injury, stress testing of a pediatric gamekeeper's fracture is not required since the amount of displacement of the SH III fragment determines the stability of the injury; - Non Operative Treatment: - indicated with less than 2 mm of displacement; - Operative Treatment: - indicated w/ more than 2 mm of fracture displacement; - consider incorporating the bony fragment into a pull out suture which is tied over a button;