The patterns of phalangeal fractures in children and adolescents: a review of 512 cases

Abstract

Introduction Fractures of the phalanges in children can often be underappreciated by the physician of first contact. Therefore it is necessary to point out which of these fractures, because of the risk of possible future complications, need special mention. Materials and Methods A retrospective review of 512 fractures of the phalanges in children and adolescents during an one year period. Fractures were subdivided into the following categories – physeal fractures, intraarticular (phalangeal neck and condylar) fractures, shaft fractures, tuft fractures, “mallet finger” fractures, volar plate avulsion injuries and collateral ligament avulsion injuries. Main outcome measures was the necessity for operation while the average age at which the injury has occured, the cause of the injury, the frequency of injury of each finger, the necessity for reduction, and the duration of splinting were the secondary outcome measures. Results Collateral ligament avulsion injuries and intraarticular (phalangeal neck and condylar) fractures were injuries which most often necessitated operative treatment. Physeal injuries were the most common injuires with avulsions of the volar plate being the second most common. Accidents during sport was by far the most common cause of injuires in all categories apart from tuft injuries. Conclusion The findings regarding the incidence and the cause of these injuries in this study support the already published dana in the literature. The physician of first contact has to be capable to recognise the problematic fractures – intraarticular (phalangeal neck and condylar), significantly displaced Salter-Harris type III and IV fractures and collateral ligament avulsion injuries and Seymour fractures.

Clinical characteristics and distribution of paediatric hand fractures at a tertiary hospital in South China: a retrospective analysis

“…This is in contrast with most previous publications that noted a high prevalence of proximal phalanx involvement [7–10,12,13,15]. Our findings may be attributed to the fact that crushing was the most common mechanism of injury and this type is likely to injure the distal phalanx [8,9,16,17]. In addition, there are several reported cases of distal phalangeal fractures commonly seen in younger children [4,12].…”

Phalangeal fractures in children

“…Dok većina prijeloma članaka prstiju šake zahtijeva kratkotrajnu imobilizaciju, za liječnike koji se u hitnom prijmu susreću s ovom kazuistikom važno je prepoznati one prijelome kod kojih bi ishodi bili bolji s operativnim liječenjem. Autori su u ranijem izvornom radu pokazali kako je kirurško liječenje zahtijevalo tek 2% svih prijeloma članaka prstiju koji su u razdoblju od jedne godine pregledani u pedijatrijskom hitnom kirurškom prijmu (5). Ovim preglednim člankom želimo uputiti na prijelome koji zahtijevaju posebnu pozornost kako bi se vjerojatnost njihova previđanja u hitnoj ambulanti smanjila.…”

Multiple Bony Mallet Finger Injuries in One Hand of a 14-Year-Old Boy

“…Avulsion fractures at the base of the distal phalanx, also known as bony mallet finger injuries, are prevalent hand injuries, particularly among active individuals [ 1 , 2 ]. Rarer still are multiple avulsion injuries affecting fingers of the same hand, which clinicians often overlook due to their infrequent occurrence [ 3 ].…”