Hand Fractures: A Study of Their Site and Type in Childhood

Arora, Rajesh; Basu, Avi; Vaidhyanath, Ram; Finlay, David B.

doi:10.1053/crad.2001.0753

“…Tuft fractures account for up to 80% of hand fractures in this age group. 4,10 These injuries can also involve soft tissue lacerations and nail bed injuries in addition to the distal phalangeal fracture, and irrigation and debridement remain the mainstay of initial treatment for these open injuries. Immobilization with a clamshell type plastic splint for 2-3 weeks will help protect the sensitive fingertip.…”

Section: Specific Injuriesmentioning

confidence: 99%

Pediatric Hand Fractures

Nellans

¹

,

Chung

²

2013

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Summary Pediatric hand fractures are common childhood injuries. Identification of the fractures in the emergency room setting can be challenging owing to the physes and incomplete ossification of the carpus that are not revealed in the xrays. Most simple fractures can be treated with appropriate immobilization through buddy taping, finger splints, or casting. If correctly diagnosed, reduced and immobilized, these fractures usually result in excellent clinical outcomes. However, fractures may require operative stabilization if they have substantial angulation or rotation, extend into the joint, or cannot be held in a reduced position with splinting alone. Most fractures can be treated operatively with closed reduction and percutaneous pinning if addressed within the first week following the injury. In children, the thick, vascular-rich periosteum and bony remodeling potential make anatomic reductions and internal fixation rarely necessary. Most fractures complete bony healing in 3-4 weeks, with the scaphoid being a notable exception. Following immobilization, children rarely develop hand stiffness and formal occupational therapy is usually not necessary. Despite the high potential for excellent outcomes in pediatric hand fractures, some fractures remain difficult to diagnose and treat.

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“…Tuft fractures account for up to 80% of hand fractures in this age group. 4,10 These injuries can also involve soft tissue lacerations and nail bed injuries in addition to the distal phalangeal fracture, and irrigation and debridement remain the mainstay of initial treatment for these open injuries. Immobilization with a clamshell type plastic splint for 2-3 weeks will help protect the sensitive fingertip.…”

Section: Specific Injuries Distal Tuft Fractures From Crush Injuriesmentioning

confidence: 99%

10 Pediatric Hand Fractures

2018

Fractures of the Hand and Carpus

0

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SummaryPediatric hand fractures are common childhood injuries. Identification of the fractures in the emergency room setting can be challenging owing to the physes and incomplete ossification of the carpus that are not revealed in the xrays. Most simple fractures can be treated with appropriate immobilization through buddy taping, finger splints, or casting. If correctly diagnosed, reduced and immobilized, these fractures usually result in excellent clinical outcomes. However, fractures may require operative stabilization if they have substantial angulation or rotation, extend into the joint, or cannot be held in a reduced position with splinting alone. Most fractures can be treated operatively with closed reduction and percutaneous pinning if addressed within the first week following the injury. In children, the thick, vascular-rich periosteum and bony remodeling potential make anatomic reductions and internal fixation rarely necessary. Most fractures complete bony healing in 3-4 weeks, with the scaphoid being a notable exception. Following immobilization, children rarely develop hand stiffness and formal occupational therapy is usually not necessary. Despite the high potential for excellent outcomes in pediatric hand fractures, some fractures remain difficult to diagnose and treat. Keywords Pediatric hand fractures; Pediatric hand injuriesA number of pediatric hand fractures have fairly innocuous presentations, but require early recognition and intervention to achieve satisfactory outcomes. Seymour fractures (open distal phalanx physeal fracture with proximal nail fold incarceration) must be identified and treated operatively to avoid infection, malunion, and nail deformities. Distal condylar phalangeal (DCP) fractures are difficult to address if not reduced at the time of injury. An osteotomy to correct a DCP malunion can be fraught with complications, and sagittal plane deformities may be able to remodel better than previously thought. Scaphoid waist fractures in adolescents, if not identified shortly after injury and immobilized appropriately, may result in non-union.

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“…Die Verletzungen erfolgen sehr häufig bei Kontaktsportarten, aber auch Unfälle beim Fahrradfahren sind beschrieben worden (Rajesh et al 2001;Rettig et al 1989;Worlock u. Stower 1986). Als Boxerverletzung ist die subkapitale Fraktur vor allem des 5.…”

Section: Ursache Und Häufigkeitunclassified