- 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