Analysis of 344 Hand Injuries in a Pediatric Population

Abstract

Background: The purpose of this study was to identify comprehensive hand injury patterns in different pediatric age groups and to assess their risk factors.

Methods: This retrospective study was conducted among patients younger than 16-year-old who presented to the emergency room of a general hospital located in Gyeonggi-do, Republic of Korea, and were treated for an injury of the finger or hand from January 2010 to December 2014. The authors analyzed the medical records of 344 patients. Age was categorized according to five groups.

Results: A total of 391 injury sites of 344 patients were evaluated for this study. Overall and in each group, male patients were in the majority. With regard to dominant or non-dominant hand involvement, there were no significant differences. Door-related injuries were the most common cause in the age groups of 0 to 3, 4 to 6, and 7 to 9 years. Sport/recreational activities or physical conflict injuries were the most common cause in those aged 10 to 12 and 13 to 15. Amputation and crushing injury was the most common type in those aged 0 to 3 and 4 to 6 years. However, in those aged 10 to 12 and 13 to 15, deep laceration and closed fracture was the most common type. With increasing age, closed injuries tended to increase more sharply than open injuries, extensor tendon rupture more than flexor injuries, and the level of injury moved proximally.

Conclusions: This study provides a comprehensive overview of the epidemiology of hand injuries in the pediatric population.

Keywords: Children; Hand injuries; Pediatric.

Fig. 1. The annual distribution of patients during the 5-year period.

No significant variation in the number of patients was found.

Fig. 2. Male-to-female ratio according to age group

0 to 3 years (1.65), 4 to 6 years (2.27), 7 to 9 years (1.35), 10 to 12 years (2.17), and 13 to 15 years (4.31). The age group 13 to 15 years showed a significantly higher ratio compared with the younger age groups (P=0.007).

Fig. 3. Proportion of dominant vs. non-dominant hand

There were no significant differences in any of the age groups.

Fig. 4. Proportion of closed vs. open injury

With increasing age, open injuries decreased and closed injuries increased.

Fig. 5. Proportion of flexor vs. extensor tendon injury

With increasing age, flexor injuries decreased and extensor injuries increased.

Fig. 6. Proportion of injury level

The younger children tended to be injured more frequently at the most distal level, and with increasing age the incidence of injuries at this level decreased.