Our Summary

This research paper discusses the unique challenges that come with treating children’s hand fractures, specifically those in the proximal phalanx, which is the bone found in fingers and toes closest to the hand or foot. It provides advice for examining the injured hand, how to properly immobilize it, and the best treatment strategies. The review emphasizes that both over-treatment and under-treatment can have negative effects. Over-treating can lead to unnecessary stiffness, missed activities, increased healthcare costs, or unneeded surgical complications. Under-treatment, on the other hand, can lead to improper healing and loss of function. The paper reviews different types of fractures that can occur in various parts of the bone. The ideas discussed in this paper aim to provide guidance on how to best evaluate and treat children with these kinds of injuries.

FAQs

  1. What are the unique considerations and challenges of paediatric hand fracture care?
  2. What can over-treatment and under-treatment of paediatric hand fractures result in?
  3. What are the common fracture patterns in paediatric hand injuries?

Doctor’s Tip

One helpful tip a doctor might give a patient undergoing hand surgery is to follow their post-operative care instructions closely to ensure proper healing and minimize the risk of complications. This may include keeping the hand elevated, performing prescribed exercises, and avoiding activities that could put stress on the healing hand. Additionally, attending follow-up appointments and communicating any concerns or changes in symptoms to the doctor promptly can help ensure the best possible outcome from the surgery.

Suitable For

Patients who are typically recommended for hand surgery include those with:

  1. Fractures of the hand or fingers that require surgical intervention for proper alignment and healing.
  2. Soft tissue injuries such as tendon or nerve damage that require surgical repair.
  3. Congenital abnormalities of the hand or fingers that require corrective surgery.
  4. Arthritis in the hand or fingers that is severe and causing significant pain and functional limitations.
  5. Tumors or growths in the hand or fingers that require surgical removal.
  6. Chronic conditions such as carpal tunnel syndrome or trigger finger that have not responded to conservative treatments and require surgical intervention.

Timeline

Before hand surgery:

  1. Patient experiences pain, swelling, and limited range of motion in the hand.
  2. Patient may undergo imaging studies such as X-rays or MRI to determine the extent of the injury.
  3. Patient may receive conservative treatment such as splinting, physical therapy, or pain management to alleviate symptoms.
  4. If conservative treatment is unsuccessful or if the injury is severe, hand surgery may be recommended.

After hand surgery:

  1. Patient undergoes the surgical procedure under anesthesia.
  2. Patient may experience post-operative pain, swelling, and stiffness in the hand.
  3. Patient will follow a rehabilitation program to regain strength and range of motion in the hand.
  4. Patient will attend follow-up appointments with the surgeon to monitor healing and progress.
  5. Patient may need to make lifestyle modifications or occupational therapy to accommodate any limitations in hand function after surgery.

What to Ask Your Doctor

  1. What specific type of hand surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. Are there any alternative treatment options to surgery that I should consider?
  5. How many times have you performed this specific type of hand surgery?
  6. What is your success rate with this surgery?
  7. Will I need to follow up with physical therapy after the surgery?
  8. What can I do to help promote healing and prevent complications after the surgery?
  9. Are there any restrictions or limitations I should be aware of after the surgery?
  10. What is the expected outcome or prognosis for my hand condition after surgery?

Reference

Authors: Chaudhry S. Journal: J Hand Surg Asian Pac Vol. 2022 Oct;27(5):761-771. doi: 10.1142/S2424835522300055. PMID: 36285762