Epidemiology of pediatric hand fractures presenting to a university hospital in Central Saudi Arabia

Abstract

Objectives: To investigate the epidemiology of pediatric hand fractures and to provide recommendations regarding prevention.

Methods: Medical records and x-rays were retrospectively reviewed for age at the time of injury, gender, fracture pattern, place where the injury occurred, and mechanism of injury. The study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between January 2005 and December 2011.

Results: Of 361 cases reviewed, there were 291 (80.6%) male and 70 (19.4%) female patients. Most (46.2%) were in the age group of 13-18 years. For age group 1-4 years, the most common place of occurrence was at home (81.3%) and for the group 13-18 years, outdoors was the place of occurrence (64.7%). Females were mostly injured at home while males had similar distribution of indoor and outdoor injuries. The most common causes of fractures were: door slams in the 1-8 years age group; falls at home, in the 9-12 years age group; and both falls at home and sports in the oldest age group (13-18 years). The little finger ray are the most frequently injured part of the hand followed by the middle finger.

Conclusion: Our series showed that most hand fractures in children occurred at home, which requires reevaluation of home settings. Implementation of safety measures during sports activities are relevant in the oldest age group.

Figure 1

Age and gender distribution among 361 pediatric hand fracture cases in King Khalid University Hospital, Riyadh, Saudi Arabia, 2005-2011.

Figure 2

The distribution of hand fractures by bone among 361 cases. The total number of fractures is 398 as some cases had multiple fractures. Also note that the little finger is the most commonly injured ray (n=150 fractures), and the proximal phalanx of the little finger is the most commonly injured bone (n=73 fractures).

Figure 3

The distribution of hand fractures by bone and age group. The total number of cases is 361, and the total number of fractures was 398. In this figure the total number of fractures shown by age distribution is only 394 as the age was missing in 4 fractures. A) 1-4 years. The distal phalanx in this age group is the most commonly injured bone (n=24) and that the little finger is the most commonly fractured ray (n=18). B) 5-8 years. The distal phalanx (n=23) and proximal phalanx (n=22) are the 2 most commonly injured bones. The little finger (n=19) remains the most commonly injured ray. Within the little finger ray, the proximal phalanx makes 14 out of 19 fractures. C) 9-12 years. The proximal phalanx (n=46) is the most commonly injured bone. The little finger (n=31) and the middle finger (n=31) have equal distribution of fractures. The proximal phalanx of the little finger (n=21) remains the most commonly injured site. D) 13-18 years. The metacarpal (n=75) is the most commonly injured bone and the little finger (n=82) is the most commonly injured ray. Within the little finger ray, the metacarpal (n=40) is the most common site of fracture in this age group.