Paediatric hand fractures

Young, Katie; Greenwood, Amy; MacQuillan, Anthony; Lee, S.; Wilson, Sandra

doi:10.1177/1753193412475045

Cited by 25 publications

(51 citation statements)

References 16 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The drop in injury rates seen in older teenagers likely represents a shift to adult facilities and not an actual decrease in injury rate. 13 Like prior reports, there was an interesting gender/age contrast in fracture rates, with higher rates in younger girls despite similar injury rates, and then shifting to older boys. 6,10…”

Section: Discussionsupporting

confidence: 48%

“…When including teenagers, the male rate rose to 56%, closer to other reports’ larger male marjorities. 4,5,9,11,13,14 This may be due to our patient population, or a consequence of capturing all injuries, and not just fractures. The drop in injury rates seen in older teenagers likely represents a shift to adult facilities and not an actual decrease in injury rate.…”

Section: Discussionmentioning

confidence: 99%

“…When evaluating distribution across the hand, we found that border digits (thumb and small finger) were injured more often than central digits, consistent with prior reports. 6,11,13 This likely correlates with their peripheral position putting them at higher risk for getting caught on passing objects. When injured, those fingers also fractured at higher rates.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Understanding the spectrum of paediatric mechanical finger and hand trauma seeking acute care

Gibly

Shomaker

Bompadre

et al. 2018

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

PurposePaediatric hand injuries are a frequent reason for acute medical evaluation. Previous studies have reported only fracture rates, surgical injuries or are limited to database diagnosis coding. The average fracture rates and injury distributions across the hand for all mechanical injuries have not been well-described.MethodsWe performed a retrospective review of all emergent/urgent care visits over 18 months at a US paediatric tertiary hospital with hand injuries recorded anywhere in the encounter. Patient, injury and encounter details were recorded with additional imaging review, categorized and described.ResultsA total of 523 patient visits (0.64% of all encounters) were for mechanical hand trauma. The injury mechanism was 42% crush, 19% jammed, 12% impact, 12% fall on outstretched hand, 7% hyperextension and 8% other/unclear. Crush was responsible for 80% of injuries in patients aged 0 to six years old but only 17% in patients aged 13 to 18 years. Crush resulted in fractures only 26% of the time, while other mechanisms were more likely to fracture (33% to 87%). Border digits were injured more often than others (21% to 23% versus 13% to 17%), and were most commonly fractured in the proximal phalanx (57% to 67% versus 22% to 34% for non-border digits). Providers correctly coded for basic fracture presence in 89.1% of injuries, but 53% of codes were not finger or laterality-specific, and only 15% specified a bony segment demonstrating that International Classification of Diseases-9 coding was nonspecific for injury patterns.ConclusionPatients with paediatric hand injuries frequently utilize emergency care and understanding the basic patterns of injury can guide resource utilization and future studies on optimal treatment algorithms in this setting.Level of EvidenceIV, Prognostic, Case Series

show abstract

Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Understanding the spectrum of paediatric mechanical finger and hand trauma seeking acute care

Gibly

Shomaker

Bompadre

et al. 2018

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

show abstract

“…[2][3][4][5] Hand fractures are the second most common fracture, accounting for one-fifth of all pediatric fractures. [2][3][4][5] Incidence of hand fractures increases with age, with peak occurrence coinciding with the onset of puberty and an increased participation in contact sports. 2 The growing skeleton has a unique capacity to heal and remodel and the majority of pediatric hand fractures are managed by immobilization with only approximately 10% requiring surgery.…”

Section: Résumémentioning

confidence: 99%

“…2 The growing skeleton has a unique capacity to heal and remodel and the majority of pediatric hand fractures are managed by immobilization with only approximately 10% requiring surgery. 3,4,[6][7][8][9][10][11][12][13] From the perspective of the referring physician, there are 2 common concerns when managing pediatric hand fractures: diminished hand function and disturbance of the growth plate. Injuries to the hand can result in major functional deficits which may affect expression, work, and play.…”

Section: Résumémentioning

confidence: 99%

Pediatric Hand Fracture Referring Practices: A Scoping Review

et al. 2019

View full text Add to dashboard Cite

Background: Pediatric hand fractures are common, but few require surgery; therefore, these fractures are often perceived to be overreferred. Our objective is to systematically identify and describe pediatric hand fracture referring practices. Method: A scoping review was performed, searching electronic databases and grey literature up to January 2018 to identify referring practices for children (17 years and younger) with hand fractures (defined as radiographically confirmed fractures distal to the carpus) to hand surgeons. All study designs were included, and study selection and data extraction were independently performed in duplicate by 2 reviewers. Outcomes included referring rates, necessity of referral, referring criteria, and management of fractures. Results: Twenty (10 cross-sectional, 7 prospective cohorts, and 3 narrative reviews) studies reporting on referring practices or management of 21,624 pediatric hand fractures were included. Proportion of pediatric hand fractures referred to hand surgeons ranged from 6.5% to 100%. Unnecessary referral, defined as those fractures within the scope of primary care management, ranged from 27% to 78.1%. Ten studies reported referring criteria, with 14 unique criteria identified. The most common referring criteria were displacement (36.4%), loss of joint congruity (36.4%), and instability (36.4%). The most common justification for these criteria was increased likelihood of requiring surgery. The most common initial management was immobilization (66%-100%). Final management was provided by orthopedic or plastic hand surgeons with 0% to 32.9% of fractures requiring surgery. Conclusion: Referring practices vary widely in the literature. Major gaps in the literature include objective measures and justification for referring criteria and primary care education on hand fracture referring practices.

show abstract

Distribution and pattern of hand fractures in children and adolescents

et al. 2023

View full text Add to dashboard Cite

Hand fractures represent commonly encountered injuries in pediatric patients. However, due to modern means of mobility and product safety, the occurrence and distribution of these fractures have changed during the last decades. Therefore, it was the aim of this study to present an update of the epidemiology, pattern, and treatment of hand fractures in a large pediatric cohort. All patients aged between 0 and 17 years treated in our Department in 2019 with fractures of the phalanges, metacarpus, or carpus were included. The medical records were reviewed for age, gender, injury mechanism, fracture localization, season, and treatment. Patients were divided into three different age groups (0–5, 6–12, and 13–17 years). A total of 731 patients with 761 hand fractures were treated during the 1-year study period. The mean age was 11.1 ± 3.5 years, and the majority was male (65%). Male patients were significantly older compared to female patients (p = 0.008). Also, 78.7% of the fractures affected the phalanges, 17.6% the metacarpals, and 3.7% the carpal bones. The proximal phalanges were the most commonly fractured bones (41.5%). Patients with fractures of the carpus were significantly older compared to children sustaining fractures of the metacarpus or phalangeal bones (p < 0.001). Sixteen percent of our patients were treated surgically; these patients were significantly older compared to conservatively treated patients (p = 0.011). Conclusion: The epidemiology, mechanisms of injury, distribution, and treatment of hand fractures significantly varies among different age groups. This knowledge is of importance for educational purposes of younger colleagues entrusted with care of children and adolescents as well as development of effective prevention strategies. What is Known:• Pediatric hand fractures represent the second most common fractures in children.• The epidemiology of pediatric hand fractures has changed during the last decades and therefore there is a need for an update regarding distribution and epidemiology of pediatric hand fractures. What is New:• In this retrospective cohort study, 761 pediatric hand fractures of 731 patients were analyzed in detail.• The main mechanisms of younger patients were entrapment injuries, older children most commonly sustained their fractures due to ball sport injuries. There was an increasing rate of metacarpal and carpal fractures with increasing age, and these fractures had to be treated operatively more often than phalangeal fractures.

show abstract

Paediatric hand fractures

Cited by 25 publications

References 16 publications

Understanding the spectrum of paediatric mechanical finger and hand trauma seeking acute care

Understanding the spectrum of paediatric mechanical finger and hand trauma seeking acute care

Pediatric Hand Fracture Referring Practices: A Scoping Review

Distribution and pattern of hand fractures in children and adolescents

Contact Info

Product

Resources

About