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The ‘Shoelace Sign’: just another simple thumb laceration?
  1. Elliott Smock1,
  2. Richmond James Colville2
  1. 1 Christine M Kleinert Institute for Hand and Microsurgery, Louiville, Kentucky, USA
  2. 2 Department of Plastic Surgery, St Georges Hospital NHS Trust, London, UK
  1. Correspondence to Elliott Smock, Christine M Kleinert Institute, Louiville, Kentucky, USA; elliott1940{at}

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Clinical introduction

A 50-year-old man presented to the emergency department in an intoxicated state. His companion states he was celebrating a promotion and while intoxicated climbed a chain-link fence, subsequently falling off and sustaining this laceration to the thumb base (figure 1). He is unable to answer any questions or co-operate with examination. A CT scan of his head is unremarkable.

Figure 1

The hand on presentation to the emergency department.

The tenodesis test of the …

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  • Contributors All authors have contributed to the submitted case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.