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Hand and fingertip injuries in children
Alexandra Fetter-Zarzeka1, Madeline Matar Joseph
1Department of Emergency Medicine, University of Florida Health Science Center, Jacksonville, 32209, USA.
Insights
Pediatric hand and fingertip injuries are common, with outdoor incidents and lacerations most frequent. Injuries show a bimodal distribution by age, with younger children sustaining fingertip injuries at home and older children experiencing sports-related hand fractures.
Area of Science:
- Pediatric Emergency Medicine
- Epidemiology of Pediatric Injuries
- Hand Surgery
Background:
- Childhood hand injuries are prevalent, yet research often emphasizes treatment over epidemiological patterns.
- Existing literature has not comprehensively addressed the specific epidemiology of pediatric hand and fingertip injuries presenting to emergency departments.
Purpose of the Study:
- To investigate the epidemiology of hand and fingertip injuries in children presenting to a pediatric emergency department.
- To identify common injury types, settings, and demographic patterns associated with pediatric hand injuries.
Main Methods:
- A retrospective chart review was conducted at a pediatric emergency center within an urban emergency department.
- Data were collected over an 8-month period, encompassing all patients presenting with a chief complaint of hand injury.
- A total of 382 pediatric patients were enrolled from 17,859 reviewed charts, with a median age of 10 years.
Main Results:
- The most common injury setting was outdoors (47%), with lacerations (30%) and fractures (16%) being the most frequent injury types.
- Digits were the most commonly injured part of the hand (particularly the thumb), and fingertips were involved in 21% of cases.
- Hospitalization was rare (1.3%), and infection occurred in 3.7% of patients. Radiographs were obtained in 64% of cases.
Conclusions:
- Pediatric hand injuries exhibit a bimodal age distribution: fingertip injuries in children under 2 (often domestic) and hand injuries in adolescents (12-16 years).
- Sports-related injuries are a significant cause of hand fractures in older children and tend to present later.
- Understanding these epidemiological patterns can inform targeted prevention strategies and clinical management for pediatric hand injuries.
Background:
Hands are frequently injured in children. To date, the literature has focused on the type and treatment of hand injuries. This study examines the epidemiology of hand and fingertip injuries in children who present to an emergency department (ED).
Design:
Retrospective chart review.
Setting:
Pediatric emergency center of an urban ED.
Participants:
All patients over a period of 8 months who presented with a chief complaint of hand injury.
Methods:
A total of 17,859 charts were reviewed during the study period; 382 patients were enrolled in the study (male preponderance of 1.4:1; median age, 10 y).
Results:
The most frequent injury setting was outdoors (47%). The most frequent injuries were lacerations (30%), followed by fractures (16%). Only five patients required hospitalization (1.3%). The digits are the most commonly injured part of the hand, particularly the thumb (19%). Fingertips are involved in 21% of cases. Radiographs and consultations were obtained in 64% and 16% of cases, respectively. Infection occurred in 14 (3.7%) patients.
Conclusion:
Hand injuries occur in a bimodal distribution in children. Children younger than 2 years suffered fingertip injuries in the home, and children aged 12 to 16 years suffered hand injuries. Sports injuries tend to present late and are the most common cause of hand fractures.