7 - Hand/Finger Fractures

Abstract

Pediatric hand fractures are one of the most common types of fractures that present to the emergency room. While the vast majority of these injuries are nondisplaced, nonphyseal, and nonarticular and can be treated nonoperatively, there are specific pediatric hand and finger fractures that are at high risk for complications, such as nonunion, malunion, or loss of motion, and challenge the misconception that pediatric fractures are best treated with minimal intervention. Identification of these injuries is paramount in order to decide on the most appropriate course of treatment. Unstable fractures patterns such as displaced proximal pole scaphoid fractures, rotationally displaced metacarpal shaft fractures, certain first metacarpal fracture patterns, Salter-Harris III and IV metacarpal head fractures, phalangeal neck and intercondylar fractures, unstable displaced phalangeal shaft fractures, and juxta-epiphyseal Salter-Harris I and II open fractures in the distal phalanx with associated nailbed laceration require more aggressive intervention.