An avulsion injury can happen in different areas of the body, with avulsion fractures being the most commonly described avulsion injuries. Written by Stephanie Chandler. Theyre also often accompanied by other serious injuries, such as broken bones, that require emergency treatment. In order to do this, the skin flap must still have good blood flow. Catawba Valley Healthcare is a 501(c)(3) comprehensive non-profit healthcare providerand is not affiliated with Catawba Valley Health Systems (CVHS), also located in Hickory. In some cases, the skin might still be partially attached as a flap near the wound. [23] Primary (baby) teeth are not replaced because they tend to become infected and to interfere with the growth of the secondary teeth. Disinfect and dry the wound thoroughly before dressing it again. Binder, D. K., Lu, D. C., & Barbaro, N. M. (2005, October). Classification and reconstructive options in foot plantar skin avulsion injuries. Multiple root avulsions from the brachial plexus. Available for Android and iOS devices. Some degloving injuries eventually result in surgical amputations. Here are the signs you may need to see a doctor. The above information is an educational aid only. 640 Abrasion Wound Stock Photos - Free & Royalty-Free Stock Photos from Dreamstime 640 Abrasion Wound Stock Photos, Images & Pictures Most relevant Best selling Latest uploads Within Results People Pricing License Media Properties More Safe Search wound puncture wound laceration burn wound bruise wound aloe vera skin abrasion laceration wound You may also have instructions regarding activity limitations to avoid movements that could interfere with your healing. Service. Successful reattachment of an almost totally avulsed ear: Use of the fluorescein test. Avram, D.R., Hurwitz, J.J., & Kratky, V. (1991, October). Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. [15] Sometimes botulinum toxin is injected into the eyelid to paralyze the muscles while the eyelid heals.[13]. An avulsion injury will usually cause severe pain and bleeding. If it becomes wet, blot it dry with a clean towel. Here's what you need to know. Your provider will tell you how long stitches or staples should be left in. You can learn more about how we ensure our content is accurate and current by reading our. A wound of this type cannot be stitched closed because there is tissue missing. Keep the wound covered and clean while healing. if needed and as directed. Your primary care provider at Catawba Valley Healthcare can be reached at (828) 695-5900. Last medically reviewed on August 14, 2018. Do not be afraid to put direct pressure on raw muscle or fat tissue. Imagine peeling a glove off your hand so that it ends up inside-out. Medication to numb the area may be given. After you suffer a cut you often bleed. In some cases, this may be done surgically, such as to relieve chronic ingrown toenails. If you have stitches, ask when to return to have them removed. Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Allow the wound to be open to the air. Skin avulsion injuries are also sometimes referred to as degloving injuries. Let's look at symptoms and treatments. DOI: Latifi R. (2013). Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Treatment usually requires an extended stay at the hospital and several surgeries, followed by several months of physical therapy. A clinicoradiological classification and a treatment algorithm for traumatic triceps tendon avulsion in adults. Very minor wounds may heal without a bandage. Treating closed degloving injuries also depends on the extent of the injury. Suprafascial avulsions are those in which the depth of the removed skin reaches the subcutaneous tissue layer, while subfascial avulsions extend deeper than the subcutaneous layer. An avulsion fracture can happen to any bone that's connected to a tendon or ligament. It is not intended as medical advice for individual conditions or treatments. Every person most likely had an open wound in the past, whether it is a small scratch from the playground or a freak accident at work. Language assistance services are availablefree of charge. Keep your wound clean and protected to prevent infection and speed healing. [13] More severe injuries require reconstruction, however, this usually results in some loss of function and subsequent surgeries may be necessary to improve structure and function. Other concerns with a cut include infection, pain, damage to structures beneath the skin, and future scars. The nail may be completely or partially torn off after a trauma to the area. When wrapping the wound, always use a sterile dressing or bandage. It can be distressing and even result in other health complications if left untreated. The doctor who placed the stitches will often recommend the number of days before this follow-up. [1] The term most commonly refers to a surface trauma where all layers of the skin have been torn away, exposing the underlying structures (i.e., subcutaneous tissue, muscle, tendons, or bone ). This can range from a mild bump or bruise to a traumatic brain injury. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. In the case of deep lacerations, bleeding can be rapid and extensive. Degloving injuries are often life threatening. For more severe cases, treatment options include: Degloving injuries are very serious on their own, but they also carry a big risk of infection since theyre often very deep wounds. 2020 Aug 6. doi:10.1007/s00167-020-06180-5, Chen HJ, Feng K, Feng XF, Wang CG, Ma ZZ. Other Types of Wounds. Download and use 200+ Avulsion Wound stock photos for free. This is because they involve large amounts of blood loss and tissue death. Pfenninger JL, et al. From outside in, they are the epidermis, the dermis, and the hypodermis. Keep the wound clean and dry for about 24-48 hours. Stitches to the skin surface can help to stop bleeding, protect underlying tissues, and lessen scarring. DOI: Wojcicki P, et al. But too much bleeding, When you get a cut or other wound, it can be hard to tell when to treat it at home and when to get stitches. Injury. Avulsion injuries will almost always need medical care, and will often need surgical intervention. Avoid sun exposure, as newly healed tissue. Your doctor may have removed the nail, put part of it back into place, or repaired the nail bed. Avulsion may happen on your finger or toe. All lip avulsion injuries were treated via wound debridement and lavage followed by appositional repair with absorbable suture material. doi:10.1111/aos.14578, Krishnamoorthy R, Karthikeyan G. Degloving injuries of the hand. An avulsion fracture is the most common type of avulsion in athletic-related injuries. Thoroughly rinse out any dirt or debris from the wound and clean the wound with soap and water. occurs when your skin scrapes against a rough or hard surface. Avoid tourniquets unless bleeding cannot be controlled and medical care will not be available for several hours. Call your healthcare provider right away if any of these occur: Redness, swelling, or pus coming from the wound, Fever of 100.4F (38C) or higher, or as directed by your provider, Stitches or staples come apart or fall out before your next appointment, and the wound edges look as if they will reopen, Surgical tape closures fall off before 7 days, and the wound edges look as if they will reopen, Bleeding not controlled by direct pressure. In the case of a severe wound, you should seek immediate medical care, especially if there is a lot of bleeding or if you cannot stop minor bleeding within 20 mins. If we combine this information with your protected An amputation refers to the loss of an extremity such as an arm, finger, or leg. [18] Until this layer has formed, the exposed nail bed is highly sensitive, and is typically covered with a non-adherent dressing, as an ordinary dressing will stick to the nail bed and cause pain upon removal. Although it can be obscured by blood, a cut is one of the easiest medical conditions to diagnose. How to treat an avulsion wound at home. Avulsion occurs when there is a partial or complete tearing away of the skin and the tissue beneath. Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes. Apply petroleum jelly to the wound and cover with a bandage to prevent dirt and germs from entering the wound. If a body part is severed, it should be brought to the hospital for possible reattachment. By Rod Brouhard, EMT-P In the case of a serious accident, you should seek immediate medical care. 18 December, 2018. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. with new bandages at least once a day or when the affected area gets wet or dirty. All rights reserved. These guidelines will help you care for your wound at home: Pelvic fractures are typically the result of high impact injuries. All Orientations. occurs when there is a partial or complete tearing away of the skin and the tissue beneath. Latifi R, et al. In some types of skin avulsion wounds, there is a flap of skin still attached. Tooth avulsions refer to situations in which a tooth is completely removed from its socket, usually with the root still attached. Try to remove the gauze in the direction of hair growth, but stop if you feel resistance due to a scab stuck to your bandage. Some people faint at the sight of their own blood (this is a neurological reaction in which a reflex slowing of the heart causes a. In an avulsion, all layers of skin are removed, so there is no way for the injury to heal from the bottom up. These spaces are known as Morel-Lavalle lesions. An avulsion fracture occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone. Thousands of new images every day Completely Free to Use High-quality videos and images from Pexels. Nearly everyone will experience an open wound at some point in their life. A skin tear (skin avulsion) is a tearing of the top layer of skin. Gently remove any dirt or other particles from the wound if you can. Warnings and Precautions. An avulsion is characterized by a flap. Be gentle with a healing cut for the first six weeks. Stitches. Your doctor may also prescribe penicillin or another antibiotic if theres an infection or high risk for developing an infection. We explain why they occur and how to prevent them from developing. Totally avulsed ear: New technique of immediate ear reconstruction. Injuries typically heal from the bottom up and from the edges in. To minimize your risk, make sure you seek emergency medical treatment so the wound is thoroughly cleaned. Clean as close to the stitches as you can. 3rd ed. Your wound is red and there are red streaks on your skin starting at your wound and moving upward. This varies depending on what part of your body they're on, and the type of wound. You can shower as usual after the first 24 hours. The five types of wounds are abrasion, avulsion, incision, laceration, and puncture. Mayo Clinic does not endorse companies or products. Always see a doctor if you have neck pain following an injury. Some materials are better because they won't stick to your cut (Telfa or Vaseline gauze). Any time layers of skin have been torn off to expose muscles, tendons and tissue, it is called an avulsion. In a skin avulsion injury, all layers of skin are gone from the wounded area. Although good wound care gives the best chance of a smaller scar, there are several factors you can't control: There are some things you can do to help minimize the possibility of scarring: 2022 WebMD, Inc. All rights reserved. It can be superficial, affecting only the surface of, When your skin gets cut or scraped, you begin to bleed. Avoid products with aspirin since they can cause or prolong bleeding. Keep everyone safe by knowing the different types of wounds, along with their treatment methods. Some open wounds can be treated at home, but this isnt always the case. Mayo Clinic Staff. An avulsion fracture occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone. To know if your child has a sprain or an avulsion fracture, the doctor or health care provider will order an X-ray of the finger. As mentioned above, skin glue will flake off by itself in 5 to 10 days. Infection is the biggest medical concern in the first few weeks. These wounds often require surgery to repair. Treating open degloving injuries depends on both the extent of the injury and hospital resources. They usually occur during violent accidents such as car crashes, explosions, and other incidents that involve trauma. [3] This is usually the result of friction forces between the climber's fingers and the holds, arising when the climber slips off a hold. How Can People Prevent Cuts and Lacerations? Puncture wounds: First aid. What Are Medical Treatments for Cuts or Lacerations? Similar to an incision, getting a laceration requires extensive cleaning and stitches. If you do feel resistance, make a saltwater solution using one teaspoon of table salt/gallon and soak your bandage-covered wound in the solution for a few minutes. National Institute of Neurological Disorders and Stroke. Others are more absorbent, provide needed surface pressure, or help to keep an injury immobile. An avulsion fracture is when a tendon or ligament pulls so hard on a bone that a piece of bone breaks off. Eyelid avulsions are uncommon,[12] but can be caused by motor vehicle collisions,[13] dog bites,[14][15] or human bites. If not, see a healthcare provider promptly. All rights reserved. You should have had a tetanus booster immunization within the last 10 years if you have a simple, clean-cut, or within the last five years if you have a more complex or dirty cut. If this happens, don't wait for your scheduled visit. Replace the flap or bring separated tissue to the hospital: If the tissue (skin, fat, and muscle) is not completely torn away, replace the flap and cover the wound. It is commonly caused by accidents involving sharp or rough objects that cut through the skin and leave some form of trauma. Keep a thin layer of antibiotic ointment on the cut. You need medical attention if you have a deep cut or if youre bleeding a lot. We avoid using tertiary references. Blood poisoning is a serious infection. For more minor cases, you may just need a combination of compression bandages, physical therapy, and rest. Treatment of essential blepharospasm: Comparison of facial nerve avulsion and eyebrow-eyelid muscle stripping procedure. Treatment for degloving injuries depends on the type, severity, and location of the injury. DOI: Hakim S, et al. This is especially true if you have thinner skin, are an older adult, or have taken steroids for long periods of time. You might be able to drive while you are healing from an avulsion fracture if your healthcare provider says that it would be safe to do so. If tendons are affected, an incision will cause heavy bleeding and possibly cause permanent damage. Granulation involves different cells, including immune cells (macrophages and neutrophils) and fibroblast cells. Steps for initially treating a skin abrasion or minor laceration: If you think your wound is infected, contact your provider for an evaluation. The most common short-term complication was wound dehiscence (21.4%). An amputation, such as getting a limb caught in a piece of heavy machinery, is also considered an . Saad Ibrahim, S. M., Zidan, A., & Madani, S. (2008). Skin avulsion is a wound that happens when skin is torn from your body during an accident or other injury. As any adult knows all too well, wounds occur in countless ways and vary broadly in severity. Thank you, {{form.email}}, for signing up. Free Avulsion Wound Photos. [20] It occurs in 1 to 2 out of every 1,000 births. A degloving injury can happen to any part of the body, such as the fingers, feet, hands, or forearm. Degloving injuries of the hand. This most often happens when you suddenly change direction. Wrap the body part in moist gauze and pack it in ice. There are two main types of degloving. [22] For intractable pain, a procedure called dorsal root entry zone (DREZ) lesioning can be effective. [26] Facial nerve avulsion is used to treat the involuntary twitching involved in benign essential blepharospasm. Are there different types of open wounds? An avulsion is a forcible tearing off of skin or another part of the body, such as an ear or a finger. Despite their different appearance, closed degloving injuries are caused by the same types of accidents that lead to open degloving injuries. To take care of a mild wound: The healing time for an avulsion wound will depend on the severity of the wound and the treatment needed to repair it.. If deep, bleeding can be rapid and heavy. Accessed May 22, 2017. Copyright Merative 2022 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. 8 First Aid Kit Essentials for Scrapes, Cuts, Bug Bites, and More. Some wounds may be treated at home and others may require a trip to your doctor for a medical approach. If surgical tape was used, it's usually best to leave it on until it falls off. An avulsion is a severe wound that can result in the partial or complete tear of the skin and tissues. It can only heal from the edges inward, and as a result may take some time to heal. Krishnamoorthy R, et al. Not all emergency rooms are equipped to handle complex skin repair. An avulsion is a severe wound that can result in the partial or complete tear of the skin and tissues. Tooth avulsion. This makes them harder for doctors to diagnose. Apart from heavy bleeding, some cases of avulsions can also lead to the loss or dislocation of limbs. Patterns and management of degloving injuries: A single national level 1 trauma center experience. In: Pfenninger and Fowler's Procedures for Primary Care. During a periosteal avulsion, the periosteum (a fibrous layer that surrounds a bone) detaches the bone's surface. Cuts in the same direction as your natural skin lines (wrinkle lines) are less visible. This commonly happens after a fall or other injury. Your wound splits open or does not seem to be healing. An avulsion is a partial or complete tearing away of skin and the tissue beneath. Eyelid avulsion: A clinical and experimental study. DOI: Jones M, et al. Pelvic avulsion fractures. Accessed May 22, 2017. General care instructions for avulsion wounds include: SOURCES:Case Reports in Ophthalmology: Management of Traumatic Lower-Eyelid Avulsion and Complete Loss of the Lacrimal Canaliculus: A Case Report.Cleveland Clinic: Avulsed Tooth, Skin.Dignity Health: Stitches.Laryngoscope Investigative Otolaryngology: Auricular avulsion injuries and reattachment techniques: A systematic review.Indian Journal of Dermatology, Venereology, and Leprology: Nail avulsion: Indications and methods (surgical nail avulsion).Johns Hopkins Medicine: Brachial Plexus Injury.Journal of Emergencies, Trauma, and Shock: The therapeutic challenges of degloving soft-tissue injuries.Main Line Health: Avulsions.Mayo Clinic: Avulsion fracture: How is it treated?Mount Nittany Health: Skin Tear (Skin Avulsion).Mount Sinai: Skin graft.Smithsonian Magazine: Ask Smithsonian: How Does Skin Heal?University of California Irvine Health: Home wound care dos and donts.. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Just as at home, the first step is to stop the bleeding. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. Chin J Traumatol. In children, avulsion fractures that involve the growth plates also might require surgery. To provide you with the most relevant and helpful information, and understand which Signs of hemorrhage include continuous bleeding that doesnt respond to direct pressure. Falls, accidents with sharp objects, and car accidents are the most common causes of open wounds. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Children injury. But don't soak the area in water (no baths or swimming) until the stitches or staples are taken out and your provider says it's OK. You can take acetaminophen (Tylenol) as directed on the package. Emotional trauma is best described as a psychological response to a deeply distressing or life-threatening experience. These are wounds to the top layer of skin, and while they often heal quickly, sometimes large and deep abrasions can get infected or cause scarring. Ring avulsion injuries. 2021 Apr 20:S0020-1383(21)00351-X. Upload. Over-the-counter scar creams are generally not harmful but they have not been proven to be effective. (2011). before caring for the wound to reduce the likelihood of a bacteria infection. The best way to speed along your recovery from an avulsion wound is to take proper care of your wound after youre sent home. Last updated on Feb 6, 2023. A cut, or laceration, is a tear or opening in the skin that occurs due to an external injury. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. When it gets wet, pat it dry. Avulsions have long healing times and can't be treated appropriately without medical care. Skin wound healing: An update on the current knowledge and concepts. Nail avulsion is extremely painful and requires adequate anesthesia by digital or wing block. A puncture is a small hole caused by a pointy object like a nail, needle, or bullet (bullet puncture). DOI: Mello DF, et al. [22] Detachment of the nerves can cause pain and loss of function in the arms, shoulders, and hands. On this Wikipedia the language links are at the top of the page across from the article title. Dog and human bites of the eyelid repaired with retrieved autogenous tissue. An avulsion fracture is when a tendon or ligament pulls so hard on a bone that a piece of bone breaks off. Copyright 2022 | Catawba Valley Healthcare | ALL RIGHTS RESERVED. Also talk with your provider if you've ever had a stomach ulcer or digestive tract bleeding. is a deep cut or tearing of your skin by items such as knives, tools, or machinery. More tears can occur when trying to remove a bandage that is stuck on. Conditions that can develop from an open wound include: Whether you have a minor or a more serious open wound, its important to take quick action. You may need to spend a few weeks on crutches if you have an avulsion fracture around your hip. Cytokines help to activate fibroblasts, which will make collagen, trigger endothelialization, and help with the formation of new blood vessels, a . Avulsions usually occur during violent accidents, such as body-crushing accidents, explosions, and gunshots. A blunt trauma injury can cause your spleen to rupture. Keep reading to learn more about this type of injury and how its treated. Here are some notable ailments that may arise from a wound infection. Falls, accidents with a sharp object, and car accidents are the most common causes of open wounds. A wound check without suture removal may be recommended after one or two days, especially if the chance of infection is thought to be higher than the usual 5%, or if changing the bandage may be difficult. If your wound is oozing, put ointment and a nonstick dressing over it. Tissue glue can be used as a barrier against common bacterial microbes. 2017;58(1-2):81-94. doi:10.1159/000454919, Sakai G, Suzuki T, Hishikawa T, Shirai Y, Kurozumi T, Shindo M. Primary reattachment of avulsed skin flaps with negative pressure wound therapy in degloving injuries of the lower extremity. In some cases, you may need surgery. However, amputations can also be done in a medical procedure to manage certain diseases such as gangrene. For severe trauma and other related concerns, do not hesitate to visit Makati Medical Center for immediate treatment. Lacerations tend to be caused by sharp objects. What to Do When You Bite Your Lip or Tongue, Fungating Breast Cancer: Wound Care, Relief, and Coping, Skin wound healing: An update on the current knowledge and concepts, Primary reattachment of avulsed skin flaps with negative pressure wound therapy in degloving injuries of the lower extremity, Outcomes of tibial avulsion fracture of the posterior cruciate ligament treated with a homemade hook plate, A clinicoradiological classification and a treatment algorithm for traumatic triceps tendon avulsion in adults, Proximal adductor avulsions are rarely isolated but usually involve injury to the PLAC and pectineus: descriptive MRI findings in 145 athletes, Traumatic choroidal injuries - classification, incidence, diagnosis and prognosis twenty-year results of Eye Injury Vitrectomy Study, Avulsion fracture, such as tibial avulsion fracture, Tendon avulsion, such as triceps tendon avulsion, Muscle avulsion, such as proximal adductor avulsion, Eye injury, such as choroidal (a layer in the back of the eye) avulsion. Successful replantation of a completely avulsed ear by microvascular anastomosis. All rights reserved. sexual orientation, gender, or gender identity. Nahai, F., Hayhurst, J. W., & Salibian, A. H. (1978, July). A head injury is an injury to your brain, skull, or scalp. doi:10.1016/j.injury.2021.04.042, Zacharia B, Roy A. This content does not have an Arabic version. information submitted for this request. How to Tell If You Need Medical Care, Treating a Cut Finger Injury, and When to See a Doctor, Bedsores: What You Should Know About Decubitus Ulcers, bleeding doesnt stop with direct pressure, bleeding is the result of a serious accident. Your toe or finger may be sore after treatment. Left alone, the surgical tape will fall off on its own over time. Eur Surg Res. If a major wound is left alone or treated incorrectly, it can lead to an infection. Epithelialization is a process of covering wound surfaces while granulation is a process of forming new connective tissue during the wound healing. With a volar plate injury, the joint will have: Pain right away and with slight movement; Bruising; Swelling; Diagnosis. Replantation of an avulsed ear, using a single arterial anastamosis. 4. Philadelphia, Pa.: Mosby Elsevier; 2011. https://www.clinicalkey.com. However, size, location, the amount of, A cut finger can happen quickly and without warning. Animal bites, for example, pose a high risk of infection. 2021 May;99(3):e387-e393. Upload Join. You feel like there is an object stuck in your wound. Hand embracing injured leg with painful place. With degloving injuries, you may need to take antibiotics. If there is still a skin flap attached to the wound, and the flap is healthy, your doctor may be able to reattach the skin into its original place. This is especially true if theres a lot of bleeding or if bleeding lasts for more than 20 minutes. You will need to keep it covered to prevent infection or more injury. An avulsion wound refers to a wound in which a part of the body has been torn off or removed through either surgery or trauma. Learn about a popular treatment for psoriasis. information is beneficial, we may combine your email and website usage information with eMedicineHealth does not provide medical advice, diagnosis or treatment. Don't wash or rub the stitches directly. What are common causes of an avulsion fracture? Most avulsion fractures heal very well without surgical intervention. (2011). Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York. If the bleeding was very difficult to stop and you are concerned that it will be out of control if you rinse the wound, then skip this step while you are waiting for professional help. Degloving injuries are serious and sometimes fatal. All rights reserved. In the case of a severe wound, you should seek immediate medical care. Degloving, also called avulsion, is a type of severe injury that happens when the top layers of your skin and tissue are ripped from the underlying muscle, connective tissue, or bone. exclude or treat people differently because of race, color, national origin, age, disability, sex, Signs and Symptoms. Jeng, S.F., & Wei, F.C. After the skin is stitched back into place, tubes will likely need to be used to remove excess fluid. Removal of your stitches is usually done at your doctor's office after 4-14 days. In brachial plexus avulsions, the brachial plexus (a bundle of nerves that communicates signals between the spine and the arms, shoulders, and hands) is torn from its attachment to the spinal cord. They require emergency care to reduce blood loss and prevent infection. The most common type of avulsion injury is a skin avulsion wound. Anomalies and curiosities of medicine: Being an Encyclopedic Collection of by George Milbry Gould, Walter . Sometimes, a bullet can cause a puncture wound. Treatment Different bandages are chosen for their different material properties. [25] A nail avulsion is performed to remove all or part of a chronic ingrown nail. irrigate wound and inspect for visible avulsed vessel, nerve, tendon, damaged skin edges staggered injury pattern proximal skin avulsion (from PIPJ to base of digit) distal bone fracture or dislocation (distal to PIPJ, often at DIPJ level) Imaging Radiographs recommended views In a. If the section of avulsed tissue is available, it can sometimes be repaired.
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