Distribution of pediatric hand fractures: age- and bone maturation–dependent differences

• Published in: Emergency radiology 2023-02, Vol.30 (1), p.33-39
• Main Authors: Hong, Shijie, Patel, Vandan, Barakat, Jude, Gendler, Liya, Guariento, Andressa, Shah, Apurva S., Nguyen, Jie C.
• Format: Article
• Language: English
• Subjects: Adolescent; Age; Bones; Child; Children; Cross-Sectional Studies; Displacement; Emergency Medicine; Female; Finger Phalanges - injuries; Finger Phalanges - surgery; Fractures; Fractures, Bone - surgery; Hand (anatomy); Hand Injuries; Humans; Imaging; Male; Medicine; Medicine & Public Health; Original Article; Radiology; Regression analysis; Retrospective Studies; Surgery
• ISSN: 1438-1435; 1070-3004; 1438-1435
• DOI: 10.1007/s10140-022-02093-7

Purpose To investigate the distribution and characteristics of fractures of bones of the hand on radiographs with respect to age and skeletal maturity of the fractured bone, and to identify predictors of surgery. Methods This cross-sectional, retrospective study included children (≤ 18 years) with hand fractures who underwent radiographic examinations (2019–2021). Fracture location, presence of displacement (≥ 2 mm), angulation (≥ 10°), articular extension, and if skeletally immature, then physeal involvement and Salter-Harris grade were recorded. Mann–Whitney U , Kruskal–Wallis, Fisher’s exact, and chi-square tests as well as logistic regression analyses were used. Results Study group of 508 (350 boys, 158 girls; median age, 11.9 years) included 575 (63% phalangeal, 37% metacarpal, and 0.3% carpal) fractures. Younger children were more likely to sustain phalangeal and older children carpal and metacarpal fractures (median ages: 10.8 vs 12.3 and 13.8 years, p