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Pediatric hand phalangeal fractures, including fingertip and epiphyseal types, generally heal well with good remodeling, though distal phalanx fractures can have poor outcomes. Neck fractures often result in permanent deformity if not corrected.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Hand surgery
Background:
- Hand phalangeal fractures are common in children.
- Understanding fracture patterns and healing potential is crucial for optimal outcomes.
Purpose of the Study:
- To analyze fracture patterns in pediatric hand phalanges.
- To evaluate healing and remodeling potential of different fracture types.
- To identify factors associated with unsatisfactory results.
Main Methods:
- Retrospective study of 203 children with hand phalangeal fractures.
- Classification of fractures based on location and type (e.g., epiphyseal, metaphyseal, comminuted).
- Assessment of clinical outcomes and radiographic evidence of bone remodeling.
Main Results:
- Fingertip fractures led to three weeks of disability with generally good outcomes.
- Comminuted fractures frequently presented as longitudinal splits.
- Epiphyseal fractures were predominantly Salter type 2; most showed good remodeling, particularly at the proximal phalanx base.
- Distal phalanx base epiphyseal fractures often had unsatisfactory results.
- Phalangeal neck fractures demonstrated no remodeling, with a high likelihood of permanent deformity if uncorrected.
Conclusions:
- Most pediatric hand phalangeal fractures, especially Salter type 2 epiphyseal fractures, remodel well.
- Fractures at the base of the distal phalanx and phalangeal neck fractures require careful management due to poor remodeling and potential for permanent deformity.
Abstract:
Fractures of the phalanges of the hand were studied in 203 children. Fingertip fractures caused disability for three weeks but usually had good results. Comminuted fractures often took the form of longitudinal splitting. Epiphyseal fractures were mostly of the Salter type 2 and metaphyseal types and usually had good results: remodelling occurred in both planes at the base of the proximal phalanx but only in the sagittal plane at the base of the middle phalanx. Epiphyseal fractures at the base of the distal phalanx often had unsatisfactory results. Fractures of the neck of phalanx showed no remodelling at all and if deformity is not corrected it is probably permanent.