Hand clinics
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Phalangeal fractures in children are common, and conservative treatment leads frequently to a good functional outcome. Articular or displaced fractures require early re-cognition and special attention, including surgery. In children, remodeling occurs primarily in the sagittal plane, and rotational deformities are often unacceptable.
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Scaphoid fractures in children are uncommon. A high index of suspicion is required in children when clinical signs and symptoms indicate a scaphoid fracture in a child. Radiographic evaluation with multiple views should be performed to assess for fracture. ⋯ Most scaphoid fractures can be treated with cast immobilization, which results in healing in the vas majority of cases. Scaphoid nonunion is usually the result of delayed presentation or missed diagnosis. Fortunately union can be achieved reliably with cast immobilization or surgical fixation.
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Metacarpal fractures in the finger rays are common injuries in children's hands. Fractures of the finger metacarpals account for 10% to 39% of all hand fractures in children,especially in the 13- to 16-year age group. ⋯ Results following appropriate care of these fractures are generally good, although complications can occur. This article reviews fractures and dislocations involving the finger metacarpals in children, provides standard treatment algorithms, and highlights potential pit-falls in their management.