The hands are a critical tool as children explore their surroundings and interact with others. As they learn and communicate, their bones and soft tissue are continuing to develop, which makes them more prone to getting injured. While adults and children can suffer from similar injuries, some of the most common traumatic injuries seen in pediatric patients include the following:
- Hand and wrist fractures
- Fingertip injuries (especially in the nail bed)
- Amputations
Aside from experiencing certain hand injuries more often than adults, children and adolescents have a slightly different bone consistency and improved ability to heal that factors into how they should be treated. They have what is known as growth plates (physes), which is the area where the bone grows and hardens.
Before the growth plates have fully developed and closed, they are particularly vulnerable to injury. Fractures that occur in the growth plates are often referred to as Salter-Harris fractures, which are divided into five types based on the patterns of injury and how they affect the zones of the growth plate. When a severe fracture occurs, this can lead to complications, like stunting the bone’s ability to grow. This is why treatment for pediatric hand injuries must consider how the growth plates are affected to protect the patient’s long-term function and development.
Symptoms of Traumatic Injuries
Since accidents involving children and adolescents can be very different, depending on their age and environment, symptoms of pediatric hand injuries will greatly vary. Younger children tend to have more injuries related to falls or the fingers getting crushed, such as getting smashed in a door. Older children tend to have more injuries caused by playing sports. Depending on the cause and extent of the injury, one or more of the following symptoms may be experienced:
- Swelling
- Bruising
- Lacerations
- Deformity
- Chronic pain
- Limited mobility
Fortunately, children tend to heal faster, and deformities can often be improved as they grow. With proper treatment from experienced hand surgeons, pediatric patients can likely get back their hand’s healthy form and function with little to no symptoms of the injury.
Making the Diagnosis
The nature of a hand injury is very important for finding the right treatment. When getting your injury looked at, you should tell your doctor any details related to the accident to give them an idea of what damage may have resulted. Your doctor will then perform a physical exam and may also need to take an X-ray, ultrasound, or other diagnostic test to determine how severe the injury is. With the help of this information, they can see the extent of your injury, including how the growth plates were affected, allowing them to move forward with recommending treatment.
Pediatric Hand Treatment & Surgery
The majority of pediatric hand injuries can be treated with non-invasive techniques. However, some require surgery to correct the problem and make sure the hand still develops and functions properly. When considering treatment, our team will recommend the least invasive option possible that can still provide the best long-term results.
One factor that is especially important when treating pediatric patients is timing. If serious injuries go untreated for too long, this can end up resulting in deformity or lasting issues with function. In a growth plate fracture, especially, the injury needs to be corrected before the growth plate closes (usually between the ages of 16 and 21). By doing so, the patient can get the best possible outcome from their treatment.
Some of the most common approaches to treating pediatric hand injuries are as follows:
- Casts or splints: In injuries like a sprain or fracture, simply preventing the injured hand, finger, or wrist from moving by using a cast or splint can be sufficient.
- Stitches: For a hand laceration, the area will be properly cleaned and stitches may be necessary to close the wound.
- Skin graft or flap: If a burn, scrape, cut, or similar injury significantly damages an area of skin, a graft may be placed or flap may be created to promote healing.
- Setting a bone: If an injury causes dislocation or a misaligned bone, your doctor may need to move the bone back into the right position before further treatment is done.
- Pins or other metal fixation: When a bone is fractured, metal pins may be surgically placed through the skin to ensure the bone fragments stay in their proper position as the area heals. These are usually removed once the broken bone has healed.
Whether the treatment for a pediatric patient’s injured hand requires one of the above approaches or a combination of them, our surgeons will go over what the treatment will entail and how to properly care for your child throughout the healing process.
When you choose the Institute for Hand Surgery at New York Plastic Surgical Group, a Division of Long Island Plastic Surgical Group, you will receive care from experienced hand surgeons who are highly skilled at performing complex pediatric procedures. Our mission is to not only help your pediatric patient feel better, but make sure their growing body continues to develop in a healthy way.
