Abstract：
BACKGROUND: Pediatric tendon injuries to the finger are rare, and their diagnosis can be challenging due to the difficulty in sensorimotor assessment in pediatric patients. Point-of-care ultrasound (POCUS) has currently been used for identifying tendon injury in adult acute care, but reports of its use in pediatric emergency departments are scarce.
METHODS: A previously healthy 14-year-old male patient visited our emergency department due to a finger laceration that occurred when he was cutting sausages using a knife. Physical examination revealed a 1.5 cm laceration over the palmer surface of the left fifth proximal phalanx. Tendon exposure was unremarkable, and the peripheral perfusion and sensation of the injured finger were intact. Flexion of the proximal and distal interphalangeal joints was limited due to pain. POCUS showed the disruption of the tendon structure over the laceration site, suggesting the flexor tendon rupture. Wound exploration by the orthopedic team revealed a transected flexor digitorum superficialis and flexor digitorum profundus and a tendon repair was performed. The patient was discharged with immobilization of the injured hand. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Pediatric tendon injuries to the finger are rare, and their diagnosis can be challenging to diagnose due to the difficulty in sensorimotor assessment in pediatric patients. POCUS can directly visualize a tendon structure without procedural sedation or radiation exposure, empowering physicians to diagnose tendon injuries and optimize patient care.
METHODS: A previously healthy 14-year-old male patient visited our emergency department due to a finger laceration that occurred when he was cutting sausages using a knife. Physical examination revealed a 1.5 cm laceration over the palmer surface of the left fifth proximal phalanx. Tendon exposure was unremarkable, and the peripheral perfusion and sensation of the injured finger were intact. Flexion of the proximal and distal interphalangeal joints was limited due to pain. POCUS showed the disruption of the tendon structure over the laceration site, suggesting the flexor tendon rupture. Wound exploration by the orthopedic team revealed a transected flexor digitorum superficialis and flexor digitorum profundus and a tendon repair was performed. The patient was discharged with immobilization of the injured hand. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Pediatric tendon injuries to the finger are rare, and their diagnosis can be challenging to diagnose due to the difficulty in sensorimotor assessment in pediatric patients. POCUS can directly visualize a tendon structure without procedural sedation or radiation exposure, empowering physicians to diagnose tendon injuries and optimize patient care.
摘要：
背景：小儿手指肌腱损伤很少见，由于儿科患者的感觉运动评估困难，因此其诊断可能具有挑战性。目前，定点护理超声（POCUS）已用于识别成人急性护理中的肌腱损伤，但是关于其在儿科急诊科使用的报道很少。
方法：一名先前健康的14岁男性患者因使用刀切香肠时发生手指裂伤而到我们的急诊科就诊。体格检查显示，左第五近端指骨的手掌表面有1.5厘米的裂伤。肌腱暴露并不显著，受伤手指的周围灌注和感觉完整。由于疼痛，近端和远端指间关节的屈曲受到限制。POCUS显示撕裂部位的肌腱结构破裂，提示屈肌腱断裂.骨科团队的伤口探查显示横断的趾浅屈肌和趾深屈肌，并进行了肌腱修复。患者因固定受伤的手而出院。为什么急诊医生应该意识到这一点？：小儿手指肌腱受伤很少，由于儿科患者的感觉运动评估困难，因此它们的诊断可能具有挑战性。POCUS可以直接显示肌腱结构，无需程序镇静或辐射暴露，使医生能够诊断肌腱损伤并优化患者护理。
方法：一名先前健康的14岁男性患者因使用刀切香肠时发生手指裂伤而到我们的急诊科就诊。体格检查显示，左第五近端指骨的手掌表面有1.5厘米的裂伤。肌腱暴露并不显著，受伤手指的周围灌注和感觉完整。由于疼痛，近端和远端指间关节的屈曲受到限制。POCUS显示撕裂部位的肌腱结构破裂，提示屈肌腱断裂.骨科团队的伤口探查显示横断的趾浅屈肌和趾深屈肌，并进行了肌腱修复。患者因固定受伤的手而出院。为什么急诊医生应该意识到这一点？：小儿手指肌腱受伤很少，由于儿科患者的感觉运动评估困难，因此它们的诊断可能具有挑战性。POCUS可以直接显示肌腱结构，无需程序镇静或辐射暴露，使医生能够诊断肌腱损伤并优化患者护理。
