A Laceration that Needed a Proper Exam, Not an X-Ray. Jazmin A. Wander, MD and David K. Barnes, MD, FACEP. | January 31, 2024

https://psnet.ahrq.gov/web-mm/laceration-needed-proper-exam-not-x-ray A Laceration that Needed a Proper Exam, Not an X-Ray In this WebM&M Spotlight Case with CE/MOC, a woman presented to the emergency department (ED) for evaluation of a laceration to the palmer aspect of her left thumb. The treating clinician documented a superficial 3cm laceration and that the patient was unable to flex her thumb due to pain. The clinician closed the laceration with sutures. Neither a sensory examination nor wound exploration was documented. No fracture or foreign body was identified on x-ray but the procedure note did not mention whether the tendon was visualized. Several weeks after discharge from the ED, the patient was still unable to flex her thumb and was referred to an orthopedic surgeon and a hand specialist who surgically repaired a laceration to the flexor tendon. The commentary discusses the importance of including neurovascular and functional testing when evaluating hand injuries and the role of diagnostic imaging as well as strategies to improve diagnosis and mitigate human error when treating hand injuries