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Hand injuries in children presenting to a pediatric emergency department
M S Bhende1, L A Dandrea, H W Davis
1Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania.
Insights
Pediatric hand injuries, including lacerations and fractures, are common in emergency departments, often occurring at home. Healthcare providers must be prepared for diverse hand trauma cases in children.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Epidemiology
- Hand Surgery
Background:
- Hand injuries represent a significant cause of emergency department (ED) visits among children.
- Understanding the epidemiology of these injuries is crucial for effective prevention and management strategies.
Purpose of the Study:
- To investigate the epidemiology of pediatric hand injuries.
- To identify common injury types, mechanisms, and demographic factors.
Main Methods:
- A retrospective chart review was conducted.
- Data were collected from patients diagnosed with hand injuries in a children's hospital ED.
- The study included 464 patients with 477 hand injuries from July to December 1989.
Main Results:
- Lacerations, soft tissue injuries, and fractures were the most frequent diagnoses.
- Most injuries (60.8%) occurred at home, with younger children sustaining lacerations/burns and older children sustaining fractures/sports injuries.
- Boys were more prone to sports-related and fight-related injuries; football was the most common sport involved.
Conclusions:
- Pediatric hand trauma is a substantial reason for ED visits.
- Emergency physicians require preparedness to manage a broad range of hand injuries in pediatric patients.
Study Objective:
To study the epidemiology of pediatric hand injuries.
Design:
Retrospective chart review.
Setting:
Emergency department of a children's hospital.
Participants:
All patients with a final diagnosis of hand injury from July through December 1989.
Interventions:
None.
Results:
Four hundred sixty-four patients (287 boys and 177 girls; median age, 10 years) with a total of 477 hand injuries were enrolled in the study. The most common types of injuries were lacerations (38.1%), soft tissue injuries (28.7%), and fractures (19.3%) and sprains (8%); most (60.8%) were sustained at home. Children with lacerations and burns were significantly younger than those with other types of hand injuries (P < .0001). Children with fractures, sprains, and sports injuries were significantly older than those with other types of hand injuries (P < .001). The fifth finger was the most commonly fractured digit (37%), and the fifth metacarpal was the most commonly fractured bone (P < .01). Boys were more likely than girls to sustain sports-related injuries (P < .05) and hand injuries resulting from first fights (P < .01). More hand injuries were associated with football than with any other organized sport (P < .01). All but 16 children (3.4%) were managed as outpatients.
Conclusion:
Hand trauma accounts for a significant number of pediatric ED visits. Physicians caring for children in the ED setting must be prepared to manage a wide spectrum of pediatric hand injuries.