A Prospective Study of Pediatric Hand Fractures and Review of the Literature

Liu, Edward H.; Alqahtani, Saad M; Alsaaran, Rasha N.; Ho, Emily S.; Zuker, Ronald M.; Borschel, Gregory H.

doi:10.1097/pec.0000000000000118

Cited by 50 publications

(79 citation statements)

References 17 publications

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“…The gender differences in the number of hand injuries and fractures in our study is similar to the results of other studies in the literature [ 3 , 5 , 6 , 7 , 9 , 14 , 15 , 16 , 17 ]. The predominance of fractures among males increases with age and is most apparent among teenagers [ 3 , 5 , 6 , 12 ].…”

Section: Discussionsupporting

confidence: 91%

Hand Injuries in the Polish Silesian Paediatric Population—An Exploratory Cross-Sectional Study of Post-Traumatic X-rays

Cebula

Modlińska

Machnikowska-Sokołowska

et al. 2020

Medicina

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Background and objectives: In the paediatric population, hand injuries are one of the most frequent injuries and the second most frequent area of fracture. It is estimated that hand injuries account for up to 23% of the trauma-related causes of emergency department visits. Not only are they a significant factor in health care costs, but they may also lead to detrimental and long-term consequences for the patient. The discrepancy observed between the published studies suggests a geographical variation in their epidemiology. The aim of this study is to determine the localisation of injuries and fractures involving the hand in the paediatric population of the Polish Silesia region. This exploratory cross-sectional study involved 1441 post-traumatic hand X-ray examinations performed at the Department of Diagnostic Imaging of the John Paul II Upper Silesian Child Health Centre in Katowice between January and December 2014. Materials and Methods: The study group consisted of 656 girls and 785 boys who were 11.65 ± 3.50 and 11.51 ± 3.98 years old, respectively (range: 1–18 years). All examinations were evaluated for the location of the injury and presence of fracture(s). Results: Finger injuries were dominant (n = 1346), with the fifth finger being the most frequently injured (n = 381). The majority of injuries were observed among children who were 11 years old (n = 176), with a visible peak in the 11- to 13-year-old group. A total of 625 bone fractures were detected. Fractures of the proximal phalanges (n = 213) and middle phalanges (n = 159) were most common, and fifth finger (n = 189) predominance was again observed. A gender-independent positive correlation was found between patients’ age and finger injuries (p < 0.01) as well as metacarpal injuries (p < 0.01). There was no correlation between patients’ age and fractures in these locations (p > 0.05). Metacarpal injuries (p < 0.01), finger injuries (p < 0.01), fractures (p = 0.01), and fractures with displacement (p = 0.03) were more common among males regardless of age. Conclusions: The results indicate that 11-year-old boys are at an increased risk of hand injuries and fractures. The distal and middle phalanges of the right hand, especially of the fifth digit, were the most susceptible to fracture localisation. Thus, injuries in these areas should be perceived as most likely to cause fractures and therefore demand careful examination.

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Section: Discussionsupporting

confidence: 91%

Hand Injuries in the Polish Silesian Paediatric Population—An Exploratory Cross-Sectional Study of Post-Traumatic X-rays

Cebula

Modlińska

Machnikowska-Sokołowska

et al. 2020

Medicina

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“…However, compared to older adults, a larger proportion of fractures in children and young adults are related to sports and relatively high impact falls and other injuries [24]. In addition to force of impact, other mechanical factors influence risk for fracture after a fall.…”

Section: Discussionmentioning

confidence: 99%

Use of proton pump inhibitors is associated with fractures in young adults: a population-based study

et al. 2015

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Purpose Proton pump inhibitors (PPIs) are associated with fracture in adults with osteoporosis. Because PPI therapy may interfere with bone accrual and attainment of peak bone mineral density, we studied the association between use of PPIs and fracture in children and young adults. Methods We conducted a population-based, case-control study nested within records from general medical practices from 1994 to 2013. Participants were 4–29 years old with ≥1 year of follow-up who lacked chronic conditions associated with use of long-term acid suppression. Cases of fracture were defined as the first incident fracture at any site. Using incidence density sampling, cases were matched with up to 5 controls by age, sex, medical practice, and start of follow-up. PPI exposure was defined as 180 or more cumulative doses of PPIs. Conditional logistic regression was used to estimate the odds ratio and confidence interval for use of PPIs and fracture. Results We identified 124,799 cases and 605,643 controls. The adjusted odds ratio for the risk of fracture associated with PPI exposure was 1.13 (95% CI 0.92 to 1.39) among children aged < 18 years old and 1.39 (95% CI 1.26 to 1.53) among young adults aged 18–29 years old. In young adults but not children, we observed a dose-response effect with increased total exposure to PPIs (p for trend <.001). Conclusions PPI use was associated with fracture in young adults but overall evidence did not support a PPI-fracture relationship in children. Young adults who use PPIs should be cautioned regarding potentially increased risk for fracture, even if they lack traditional fracture risk factors.

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“…Apart from head injuries, the hand is the most commonly injured part of the body in young children and hand fractures are the leading cause of morbidity in children. 24,25 Literature shows proximal phalanx fractures are the most common type of hand frac tures in children. 8 Furthermore, in a prospective study inves tigating hand injuries in children, Liu et al found that they more common in males, and that the vast majority of injuries were nonsurgical and associated with athletic activities.…”

Section: Discussionmentioning

confidence: 99%

Use of a Multivector Mandibular Distractor for Treatment of Pediatric Proximal Interphalangeal Joint Pilon Fractures: A Case-Based Review

et al. 2017

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Management of pediatric pilon fractures is rarely described and presents unique considerations. Early-stage traction and immobilization using a multivector mandibular fixator/distractor is suitable in a child because noncompliance is avoided and there is a decreased risk for stiffness. Combining early immobilization with subsequent-staged AROM, PROM, and strengthening resulted in no loss of ROM and maintained articular symmetry.

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A Prospective Study of Pediatric Hand Fractures and Review of the Literature

Abstract: The pattern of pediatric hand fracture in different age groups is highlighted in this article. The observations from this study will hopefully encourage further review with a larger cohort and a focus on preventative measures for pediatric hand fractures.

Cited by 50 publications

References 17 publications

Hand Injuries in the Polish Silesian Paediatric Population—An Exploratory Cross-Sectional Study of Post-Traumatic X-rays

Hand Injuries in the Polish Silesian Paediatric Population—An Exploratory Cross-Sectional Study of Post-Traumatic X-rays

Use of proton pump inhibitors is associated with fractures in young adults: a population-based study

Use of a Multivector Mandibular Distractor for Treatment of Pediatric Proximal Interphalangeal Joint Pilon Fractures: A Case-Based Review

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