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Pediatric Hand Trauma: Demographics, Injury Patterns And Operations
Michael Marallo, MD, Elizabeth Moroni, MD, Nallammai Muthiah, BS, Meeti Mehta, BS, Casey Zhang, BS, Alexander Davit, MD.
University of Pittsburgh Medical Center
2022-01-05
Presenter: Meeti Mehta BS
Affidavit:
The work within this abstract is original work completed by the authors listed.
Director Name: Vu T Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Purpose: Hand trauma is extremely common in children but the epidemiology and injury patterns for this group are not well described. This study examines the pediatric hand trauma population and their injury characteristics to identify risks associated with operative injuries.
Methods: This was a retrospective cohort of pediatric hand trauma patients from 2010-2020. Patients were grouped into operative and non-operative cohorts for comparison. All charts were abstracted for demographic and clinical details. Population estimates and socioeconomic data were obtained from the United States Census Bureau. Summary statistics were computed, and a Poisson regression was used to compute relative risks (RR).
Results: 1,175 patients were identified. The most common injuries were sports-related (n=397, 34%), door-slams (n=191, 17%), falls (n=137, 12%), mishaps (n=125, 11%), and violence-related (n=105, 9%). 179 patients (15%) required surgery, 996 (85%) were non-operative. The small finger was the most common digit injured (n=392, 33.4%), but ring finger injuries were more frequently operative (RR 1.34, CI 1.03-1.76, p=0.03). Phalangeal fractures were the most common (n=699, 59%), but metacarpal fractures (n=203, 17%) were more likely to be operative (RR 1.3CI 1.00-1.86, p=0.047). Patients using motorized toys or vehicles and patients aged >10 years had the highest risk of operative injury. (RR 3.99, CI 2.06-7.76, p<0.001; RR 1.39, CI 1.20-1.61, p<0.001, respectively).
Conclusions: We believe this represents the largest reported cohort in pediatric hand trauma to date, and our findings highlight several risk factors for operative injuries. Older Caucasian males and children who play with motorized devices/scooters are at highest risk.
