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Violence-Related Pediatric Hand Trauma: Epidemiology, Injury Patterns, 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
Violent hand trauma in pediatric patients has severe impact, but its epidemiology and injury patterns are not well described. This study characterizes injuries among pediatric hand trauma patients to identify risks of violent hand trauma.
Methods
This was a retrospective cohort of pediatric hand trauma patients from 2010-2020. Patients were grouped into violent/non-violent 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 124 (9.5%) violent injuries. The most common violent mechanisms were punching objects (n=46, 37.1%), assault (n=32, 25.8%), punching people (n=28, 22.6%), and accident (n=18, 14.5%). Displaced fractures, puncture injuries, and tendon injury had greater risk of violence (RR 1.55, CI 1.30-1.86, p<0.001; RR 4.94, CI 1.68-14.50, p=0.001; RR 2.16, CI 1.15-4.05, p=0.02). Small (n=65, 52.4%) and ring fingers (n=37, 29.8%) were the most injured digits, and had greater risk of violent mechanism (RR 1.39, CI 1.11-1.75, p=0.008; RR 1.45, CI 1.02-2.06, p=0.04, respectively). Metacarpal fractures were the most common injury type (n=74, 59.7%), with increased risk of violence (RR 4.85, CI 3.97-5.91, p<0.001). Male gender, African American race, and age >12 years were associated with violent mechanisms (RR 1.24, CI 1.12-1.37, p<0.001; RR 2.13, CI 1.72-2.62, p<0.001; RR 2.06, CI 1.83-2.31, p<0.001, respectively).
Conclusion
This represents the largest reported cohort in pediatric hand trauma to date, and our findings highlight several risk factors for violent hand injuries. Adolescent African American males are at highest risk.
