Paediatric Hand Fractures - A Review

Area of Science:

• Orthopedic Surgery
• Pediatric Traumatology
• Hand Surgery

Background:

• Paediatric hand fractures constitute 25% of hand ED visits, second only to distal forearm fractures.
• These injuries are more common in boys, peaking between ages 9-14, often resulting from crushing or sports injuries.
• The little finger and thumb are most frequently affected, with phalangeal fractures being common.

Purpose of the Study:

• To review the epidemiology, fracture patterns, diagnostic challenges, and management strategies for paediatric hand fractures.
• To highlight methods for optimizing functional outcomes and minimizing long-term complications.
• To emphasize the importance of specialized care for complex cases.

Main Methods:

• Review of existing literature on paediatric hand fractures.
• Analysis of epidemiological data, common fracture patterns, and diagnostic difficulties.
• Discussion of current non-operative and operative management strategies.

Main Results:

• Accurate diagnosis is challenging due to clinical examination difficulties and growth plate (physeal) variations, leading to an 8% misdiagnosis rate.
• Most paediatric hand fractures can be managed non-operatively with splinting or casting due to excellent bone remodeling potential.
• Surgical intervention may be necessary for fractures with significant displacement, intra-articular extension, or open wounds.

Conclusions:

• Paediatric hand fractures, while common, generally have excellent outcomes with appropriate management.
• High-quality imaging and thorough clinical assessment are crucial for accurate diagnosis, considering growth plate anatomy.
• Specialized care is essential for challenging cases to ensure optimal functional recovery and prevent long-term issues.