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Pediatric Firearm Injuries of the Hand
Meeti Mehta, BS; Anne E. 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
Purpose
Firearms are the second leading cause of mortality in children, but risk factors for pediatric hand firearm injuries are not well described. This study examines the pediatric hand trauma population to identify risks associated with firearm injuries.
Methods
This was a retrospective cohort of pediatric hand trauma patients from 2010-2020. Patients were grouped into firearm/non-firearm 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
1,317 patients sustained hand trauma, with 22 (1.7%) firearm injuries. The most common firearms were air rifles (n=11, 50%), and pistols (n=9, 40.9%). The most common mechanisms were intentional assault (n=9, 40.9%), accidental assault (n=7, 31.8%), accidental self-inflicted discharge (n=5, 22.7%), and intentional self-inflicted discharge (n=1, 4.5%). Injuries of the palm/dorsal hand and webspace were common (n=4, 18.2%, each), associated with greater risk of firearm involvement (RR 10.97, CI 3.51-34.32, p<0.001; RR 34.22, CI 6.74-173.61, p<0.001, respectively). Nerve injuries were less common (n=3, 13.6%), but had greater risk of firearm involvement (RR 4.06, CI 1.36-12.16, p=0.01). Open, and comminuted fractures more frequently involved firearms (RR 4.55, CI 3.27-6.34, p=0.02; RR 7.72, CI 3.89-15.30, p=0.003, respectively). Lastly, African American race had greater risk of firearm injury compared to other races (RR 2.00, CI 1.31-3.08, p=0.007).
Conclusions
This represents the largest reported cohort in pediatric hand trauma to date, and our findings highlight several risk factors for firearm injuries. African Americans with palm/dorsal hand, webspace, nerve injuries have highest risk.
