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Violence Related Hand Injuries in the Pediatric Population
JOHNSON C, PARENT B, ANSTADT E, CLAYTON-FANTUZZO J, DAVIT A.
University of Pittsburgh Medical Center
2019-02-15
Presenter: Chelsey Johnson
Affidavit:
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Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
BACKGROUND:
Pediatric hand trauma secondary to violence is a unique subset of injuries, yet a detailed analysis of the characteristics and outcomes remains understudied in this field. The aim of this study was to characterize the demographics, injury patterns, interventions, and predictive factors. Our hypothesis, is that compared to other mechanisms, violence injuries have more severe injury patterns and thus, are more likely to require operative interventions.
METHODS:
A retrospective review of patients less than 18 years of age presenting to the emergency department of a pediatric level I trauma center between 2010 and 2018 with hand trauma secondary to violence was performed. Statistical analysis was executed utilizing Poisson regression to compute relative risks with 95% confidence intervals and p-values.
RESULTS:
A total of 82 patients met the inclusion criteria for the study. Mean age for these injuries was 15.2 compared to 10.8 for other hand injuries such as sports related. Males more frequently presented with these injuries as compared to females (78% vs. 22%). African Americans are disproportionately affected by violent mechanisms compared to other races (51%). The most common injury pattern was the dominant hand metacarpal (57%) fracture of the fourth (31%) or fifth (49%) digit.
CONCLUSIONS:
Pediatric hand trauma related to violence is significantly correlated with demographics of an older male African American population. Violent mechanisms are significantly more likely to produce displaced fractures as compared to other mechanisms; however, violent mechanisms do not seem to increase the need for operative intervention. Social interventions may be indicated to temper violence in certain populations.
