Hand trauma under six years of age

Trauma alla mano sotto i sei anni

Nunzio Catena 1, Chiara Arrigoni 1, Alessandra Galuppi 2, Annalisa Valore 3, Filippo M. Senes 4

1 Reconstructive Surgery and Hand Surgery Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy; 2Traumatology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy; 3 Consultant Hand Surgery, Pederzoli Hospital, Peschiera del Garda, Italy; 4 Consultant Hand Surgery Unit, S. Giuseppe Hospital Multimedia Group, Milano, Italy

DOI 10.53239/2784-9651-2023-18

Introduction. The use of the hand in daily activities undergoes an increase in the first years of age in relation to their increased interaction with their surroundings.

For this reason, hand injuries are among the leading causes of access to pediatric emergency rooms.

Although the majority are minor trauma, there is a percentage of cases with risk of long-term outcomes such as retracting scars, sensitivity disturbances, and reduced residual growth.

The literature is poor with studies focused on pediatric hand trauma, especially in preschool age. The purpose of the study was to analyze the incidence of these injuries in a pediatric population under 6 years of age.

Materials and methods. The authors performed a review of patients presented at the pediatric emergency department of the Gaslini Institute in Genoa during the period from 2015 to 2021.

Inclusion criteria in the study were:

  • trauma distal to the wrist (distal radius and carpus excluded);
  • age less than 6 years;
  • no previous treatment.

Results. Out of 1356 patients evaluated for trauma involving the hand, 390 of these met the inclusions criteria.

The male was involved more than the female; the main trauma was finger-cutting injuries, followed by crushing and palmar wounds.

The main traumatic mechanisms found were accidental closing of the fingers in a door or car door or chairs, wounds following accidental knives use and animal bites.

The index finger was found to be the mainly injured, followed by the thumb and ring finger.

The age group between 1 and 4 years was prone to have the majority of patients.

362 children were treated in the emergency room while only 28 required hospitalization and surgery.

Conclusions. Analysis of the study data allows the authors to conclude that, although these are frequent injuries, they are often minor and do not require hospitalization.

However, there is a need for the implementation of educational prevention programs that make both adults and children aware of the potential risks present in both home and non-domestic and school environments.

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