Hand Injuries in Children

Abstract

The purpose of this prospective clinical study was to identify the true incidence, pattern, and location of the injury and nature of fracture after hand injuries in different pediatric age groups attending a hand unit. Three hundred sixty children (237 boys, 123 girls) under 16 years of age who presented with hand injuries between April 1, 2000, and Sept. 30, 2000, were included in the study. Bony injuries accounted for 65.5% (236 injuries); 33.3% (120 injuries) were soft tissue injuries. The projected annual incidence rate for skeletal injuries was 418/100,000 children. The incidence was low in toddlers (34/100,000), more than doubled in preschool children (73/100,000), and steeply increased to around 20-fold after the 10th year (663/100,000). Girls had a higher incidence of hand injuries among toddlers and preschool children. Crushing was the most common cause of hand injury (64%), and most injuries were sustained at home (45%). Toddlers sustained soft tissue injuries predominantly (86%) and older children sustained more bony injuries (77%). Sport was the cause of injures commonly in the older children. There was a higher incidence of fracture in the little finger (52%) followed by the thumb (23%). The proximal phalanx was the most frequently fractured bone (67%) among the phalanges. Diaphyseal fractures (46%) were more common in the metacarpals, and basal fractures (51%) were common in the phalanges. At discharge more than 80% of the patients felt that they were cured or significantly better. This paper highlights the changing pattern and the different varieties of hand injuries in different pediatric age groups.

Analysis of Hand Injuries in Children Between 0-6 Years of Age

“…The reported annual incidence rates showed wide ranges due to this studies have dealt with the pediatric population as a single group. 4,[11][12][13][14][15] Whereas there are very few studies on hand injuries in 0-6-year age group in the literature; in our country, studies in hand injuries of 0-16 years of age are also in limited number. Although, there are several studies analyzing epidemiology of hand injuries in children conducted in different countries and geographic regions, similar injury patterns seem to occur.…”

“…1,2 The rate of hand injuries among all patients admitted to a children's emergency department was reported to be 1-2.1% by Fetter-Zarzeka et al 3 Vadivelu et al reported the projected annual incidence rate for skeletal injuries for under 16 years of age group was 418/100,000. 4 Ljungberg et al reported the incidence of hospitalized children with hand and forearm injuries as 39.6/100,000 in the 0-6-year age group and 42.1/100,000 in the 7-14-year age group. 5 In our country, Bostancı et al stated that 8.6% of patients admitted to children's emergency clinics had upper extremity injuries.…”

Pediatric hand and wrist injuries

“…Of all phalangeal fractures, proximal phalanx fractures are most common [37,39]. They can be divided into base, shaft, neck, and condylar fractures.…”

“…Metacarpal fractures can be divided into head, neck, shaft, and base fractures, with neck and shaft fractures being the most common [37,38]. Metacarpal head fractures in children are rare.…”

The Burden of Hand Injuries in Delta State, Nigeria

“…2 Injuries of the hand have been noted to have an enormous impact on hand function and on quality of life. 3 In this era of industrialization and reliance on machines, hand injuries are on the increase worldwide, accounting for 10-15 percent of admissions in emergency departments in the developed countries 4,5 . In Uganda's largest hospital 6% of all trauma admissions in the emergency department are hand injuries.…”