Article

The hand is the most commonly injured location of a child. Fractures of the
digits are the most frequent lesions with two specific locations: 1) in the young
child, the fracture is usually a crush injury, such as occurs when a hand gets
caught in a door, with lesion of the distal phalanx; soft tissue associated
injuries are the main problem in this location ;
2) in the older child, the
fracture is usually secondary to recreational sports, with lesion on the proximal
phalanx of the second and fifth digits. Dislocations or sprains are less common.
Most interphalangeal joint injuries occur at the proximal interphalangeal joint
and are secondary to hyperextension with as results a volar plate injury. Most
fingers injuries in children are treated non operatively with a favorable
outcome. The treating physician should however identify those clinical situations
that require surgery, as complications are most commonly due to a failure to
identify and treat an injury requiring an operation acutely. These injuries
include intra-articular fractures, displaced phalangeal neck fractures, and
malrotated fractures. Malrotation or intra-articular malunion have no remodeling
capacity. Non-union and stiff digits are uncommon but a significant trauma or a
high-energy mechanism with severe soft tissues injuries appears to be a factor of risk.
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Langue : FRANCAIS