<< Back to the abstract archive
Phalangeal Injury in Pediatric Hand Trauma: An Analysis of Epidemiology and Risk Factors
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 and injury characteristics to identify risks associated with phalangeal injury.
Methods
This was a retrospective cohort of pediatric hand trauma patients from 2010-2020. Patients were grouped into phalangeal and non-phalangeal injury cohorts. 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 754 (57.5%) phalangeal injuries. The most common mechanisms were sports (n=307, 41%), door slam (n=145, 19%), fall (n=84, 11%), and household mishap (n=78, 10%). 93 patients (12%) required surgery. Buckle fractures were most likely to involve phalanges (RR 5.58, CI 1.73-18.01, p=0.001). Open fractures were the most common (n=159, 21%), and open, and Salter-Harris fractures more frequently involved phalanges (RR 3.58, CI 2.19-5.86, p<0.001; RR 4.73, CI 1.90-11.76, p<0.001, respectively). Fingertip injury was the most common soft tissue injury (n=158, 21%), and had greater risk of phalangeal injury (RR 1.64, CI 1.21-2.21, p<0.001). Age > 12 years, and violent/motor vehicle/self-inflicted mechanisms were associated with reduced risk of phalangeal injury (RR 0.42, CI 0.34-0.52, p<0.001; RR 0.22, CI 0.13-0.37, p<0.001; RR 0.16, CI 0.04-0.60, p=0.002; RR 0.03, CI 0.01-0.12, p<0.001, respectively). Female patients had higher risk of phalangeal injury (RR 1.37, CI 1.13-1.65, p<0.001).
Conclusion
This represents the largest reported cohort in pediatric hand trauma to date, and our findings highlight several risk factors for phalangeal injury. Younger females with fingertip injuries are at highest risk.
