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Hand injuries in children: a prospective study
Ramanan Vadivelu1, Joseph J Dias, Frank D Burke
1University Hospitals of Leicester NHS Trust, Leicester, England.
Insights
Pediatric hand injuries are common, with bony fractures increasing significantly after age 10. Toddlers more often sustain soft tissue injuries, while older children experience more fractures, particularly in the little finger.
Area of Science:
- Orthopedics
- Pediatric Traumatology
- Hand Surgery
Background:
- Hand injuries are a significant concern in pediatric populations.
- Understanding injury patterns across different age groups is crucial for effective treatment and prevention.
Purpose of the Study:
- To determine the incidence, pattern, location, and fracture nature of hand injuries in various pediatric age groups.
- To analyze age-specific trends in pediatric hand trauma.
Main Methods:
- Prospective clinical study including 360 children under 16 years with hand injuries.
- Data collected on injury type, cause, location, and fracture details over a six-month period.
- Incidence rates projected annually per 100,000 children.
Main Results:
- Bony injuries (65.5%) were more common than soft tissue injuries (33.3%).
- Skeletal injury incidence increased dramatically with age, from toddlers (34/100,000) to older children (663/100,000).
- Crushing injuries at home were most frequent; sports-related injuries common in older children. Little finger fractures predominated (52%).
Conclusions:
- Hand injury patterns in children vary significantly by age, with a notable shift towards bony injuries in older children.
- The incidence of skeletal hand injuries escalates sharply after age 10.
- This study underscores the need for age-tailored prevention and management strategies for pediatric hand trauma.
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.
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