Anatomical distribution and treatment of paediatric hand fractures: a multi-centre study of 749 patients in the Netherlands

Abstract

This study describes the anatomical distribution of paediatric metacarpal and phalangeal fractures and evaluates treatment methods for each fracture type. A multicentre study was conducted over a 3-month period in the Netherlands. A total of 749 consecutive patients, aged 0–17 years, with single metacarpal or phalangeal fractures were included. Physeal fractures of the proximal phalanx were most common ( n = 135, 17%), followed by proximal interphalangeal joint palmar plate avulsion fractures ( n = 81, 10%) and proximal phalanx shaft fractures ( n = 80, 10%). Treatment methods varied: 63 (47%) patients with proximal phalanx physeal fractures were allowed mobilisation of their fingers, while 70 (51%) were immobilised; 53 (65%) patients with proximal interphalangeal joint palmar plate avulsion fractures were allowed mobilisation, while 28 (35%) were immobilised; and 33 (41%) patients with proximal phalanx shaft fractures were allowed mobilisation, while 42 (52%) were immobilised. The study identified substantial treatment variability in common fractures, providing information and insights for future research directions. Level of evidence: II