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Understanding Sports-Related Pediatric Hand Trauma

Erin Anstadt MD, Brodie Parent MD, Chelsey Johnson MD, Justine Kim MD, James Fisher PhD, John Fowler MD, Alexander Davit MD
University of Pittsburgh Medical Center
2020-02-10

Presenter: Erin Anstadt

Affidavit:
Vu Nguyen

Director Name: Vu Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand

BACKGROUND:
Athletic exposure is an important risk factor for pediatric hand injuries, yet studies elucidating the epidemiology, severity and surgical management practices across ages are lacking. This study aims to analyze sports-related pediatric hand injury patterns to identify risk factors and better understand treatment needs.

METHODS
This is a retrospective cohort study of patients (age ≤18 years) that were evaluated from 2010-2019 in the emergency room of a tertiary pediatric hospital for hand trauma and referred to a hand surgeon. Patient demographic, injury, treatment data were analyzed using descriptive statistics and Poisson regression models.

RESULTS
Of 1048 patients reviewed, 358 experienced a sports-related injury (34%). 62% of injuries occurred in full-contact sports settings. Football and basketball yield the most injuries, comprising 27% and 25% of all athletic injuries respectively. Sports-related injuries demonstrate a relatively higher frequency of phalangeal fractures compared to other mechanisms (72% and 54% respectively). Within athletic injuries, the small finger and thumb are most commonly affected. Sports-related hand fractures are less likely to be comminuted (RR 0.3, CI 0.15-0.59, p <0.001) and open (RR 0.21, CI 0.12-0.38, p <0.001) compared to other mechanisms, but are not more likely to require surgery (RR 0.79, CI 0.56-1.12, p<0.19). In all, surgery was performed in 14% of injuries related to sports.

CONCLUSION
Acute sports-related pediatric hand injuries are prevalent. An understanding of injury rates, patterns, and risk factors facilitates targeted preventative measures to reduce the risk of injury for children in all sports.

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