Abstract
Closed degloving injuries of the thumb, resulting in a complete empty thumb, are rare and challenging to manage, particularly in pediatric patients. This case report presents a six-year-old boy who suffered a closed degloving injury of the right thumb due to pinching by a printing machine. The patient presented with mild skin changes, decreased circulation, and radiographic findings of bony structure separation from the soft tissue, resulting in a ghost finger appearance. Immediate surgical intervention was required due to poor circulation. Closed reduction was unsuccessful, necessitating open reduction via a volar Bruner incision. Intraoperatively, the bones and tendon structures were found to be completely separated from the surrounding soft tissues as a single unit, with intact bones, tendons, pulleys, and stretched but intact ulnar and radial proper digital arteries and nerves. The finger was reattached to the distal bone using a pull-out method and stabilized. Postoperatively, no wound or circulatory issues were encountered, and full interphalangeal and metacarpophalangeal joint movements were observed. This case highlights the importance of prompt recognition and appropriate management of closed degloving injuries of the thumb to prevent potential complications and improve functional outcomes in pediatric patients.

Key words: closed degloving injury, empty thumb, empty phenomenon