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[Hand injuries in children]
1Service de chirurgie orthopédique et réparatrice de l'enfant, université Paris VI, hôpital Trousseau, 26, rue du Docteur-Netter, 75012 Paris, France.
Insights
Pediatric hand injuries are common, often treated nonoperatively due to healing potential. Surgery is reserved for severe fractures, with percutaneous methods favored for phalangeal neck fractures.
Area of Science:
- Pediatric Orthopedics
- Pediatric Traumatology
- Hand Surgery
Background:
- The hand is a frequent site of injury in children.
- Young children's injuries stem from unawareness, while older children sustain them during sports.
- High remodeling potential in pediatric bones influences treatment strategies.
Purpose of the Study:
- To review the epidemiology and management of pediatric hand injuries.
- To outline indications for surgical intervention in pediatric hand trauma.
- To discuss optimal treatment for specific fracture types and potential complications.
Main Methods:
- Review of current literature on pediatric hand trauma.
- Analysis of nonoperative and operative treatment approaches.
- Discussion of fracture classification and management guidelines.
Main Results:
- Most pediatric hand injuries are managed nonoperatively.
- Surgical intervention is necessary for open/unstable fractures, displaced intraarticular fractures, and displaced phalangeal neck fractures.
- Percutaneous techniques are recommended for phalangeal neck fractures.
Conclusions:
- Nonoperative management is effective for most pediatric hand injuries.
- Careful selection for surgical treatment is crucial, with percutaneous fixation being a preferred method for certain fractures.
- Monitoring for growth disturbances after physis fractures is essential.
Abstract:
The hand is one of the most commonly injured locations in children. In the young child, the ignorance of dangers may explain this frequency. In the older child, hand trauma is usually secondary to recreational sports. Most hand injuries in children are treated nonoperatively because of high remodeling potential. Surgical treatments are mandatory in case of open or unstable fracture, displaced intraarticular fractures and displaced phalangeal neck fractures. In phalangeal neck fractures, percutaneous treatment should be preferred. Finger stiffness and non-union are uncommon and are usually in relation with skin or vascular involvement. In case of physis fracture, clinical and radiological follow-up should monitor any growth problems.
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