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Epidemiology and Risk Factors of Pediatric Metacarpal Injury
Meeti Mehta, BS; Anne Glenney, BA; Alexander J. Davit, MD
University of Pittsburgh School of Medicine
2023-02-10
Presenter: Meeti Mehta
Affidavit:
Meeti Mehta
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Introduction
This study examines the pediatric hand trauma population to identify risks associated with metacarpal injury.
Methods
This was a retrospective cohort of pediatric hand trauma patients from 2010-2020. Charts were abstracted for demographic and clinical details. Summary statistics were computed, and binomial regression was used to compute relative risks (RR).
Results
1,311 patients sustained hand trauma, with 215 (18%) metacarpal injuries. The most common mechanisms were sports (n=61, 28%), violence (n=40, 19%), self-inflicted (n=31, 14%), and fall (n=22, 10%). Violent, self-inflicted, and motor vehicle crash mechanisms had greater risk of metacarpal injury (RR 8.74, CI 5.17-14.77, p<0.001; RR 25.73, CI 10.13-65.39, p<0.001; RR 4.15, CI 1.35-12.74, p=0.007, respectively). In contrast, door slam mechanism had reduced risk of metacarpal injury (RR 0.09, CI 0.04-0.25, p<0.001). 39 patients (18%) required surgery, which was associated with increased risk of metacarpal injury (RR 1.44, CI 1.03-2.00, p=0.03). Displaced fractures were the most common (n=115, 53%), and had greater risk of metacarpal injury (RR 1.59, CI 1.37-1.86, p=0.001). Rotational abnormalities had increased risk of metacarpal injury (RR 2.11, CI 1.18-3.77, p=0.01). Male gender, African American race, and age >12 years had greater risk of metacarpal injury (RR 1.22, CI 1.11-1.34, p<0.001; RR 1.45, CI 1.16-1.81, p=0.002; RR 1.77, CI 1.56-2.00, p<0.001, respectively).
Conclusion
Our findings highlight several risk factors for metacarpal injury. Teenage African American males are at highest risk for metacarpal injury, and displaced fractures/rotational abnormalities increase risk of injury. These findings have important implications for prevention and early evaluation of metacarpal injuries.
