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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Flail Chest-II01:26

Flail Chest-II

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
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Paediatric Hand Fractures - A Review.

Renita Sirisena1, Shilu Shrestha2

  • 1Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.

The Journal of Hand Surgery Asian-Pacific Volume
|November 15, 2024
PubMed
Summary

Paediatric hand fractures are common, especially in boys aged 9-14, often affecting the little finger. Most heal well with non-operative treatment, but complex cases require surgery for optimal outcomes.

Keywords:
Conservative treatmentDiagnosisPaediatric hand fracturesRemodelling potentialSurgical intervention

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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.