HAND INJURIES

Hand Injuries

Hand injuries affect the fingers, hand, and wrist. It can cause vascular trauma which implies that the blood vessel has been injured. If you suspect your child has broken his or her hand, you can bring him or her to Medical City Children’s Orthopedic and Spine Specialists Fracture Care Clinic where a pediatric orthopedic specialist will diagnose and treat your child.

Common Hand Injuries

The most common sports-related hand injuries include fractures, ligament & tendon injuries, and dislocations. For example, football, field hockey, and lacrosse, where the chance of being tackled is high, are responsible for most of the bones of the hand that are broken in children. Also, a scaphoid fracture (i.e. a break in one of the small bones in the wrist) usually occurs when a child falls on an outstretched hand.

Strains and sprains occur in cheerleading, gymnastics, and weight lifting. They can lead to the inflammation or irritation of a tendon as a result of repetitive motion.

Fractured or Broken Hand

Fractures are cracks or breaks in bones. Children and teens may break their finger or thumb bones (phalanges, fah-LAN-jeez). Additional breaks are their wrist bones (carpals) or the long bones between their fingers and their wrist (metacarpals). Most hand fractures happen when a child falls on their hand.

• Their hands get twisted, bent, or smashed.
• The child hits (or gets hit by) something hard.
• In toddlers breaks often happen when the tip of their finger gets caught in a door.
• Older children tend to get breaks during sports or other active play.

An injury that breaks a bone may also damage a child’s growth plates or soft tissues. Such as skin, ligaments, or tendons. In addition, damage to growth plates or soft tissues may affect the way doctors treat your child’s fracture. Furthermore, seeing a pediatric orthopedic specialist who focuses on treatment options based on the location of the fracture and whether or not it will affect the growth plates is extremely important for the future of your child’s recovery.

Hand Injuries and Fractures are very common in children and teens. About half of all boys and a quarter of all girls break a bone sometime before adulthood. Children are flexible, so their bones may bend after a break. They may straighten out as they heal. Doctors refer to this process as remodeling. Because of remodeling, a young person’s broken bone will heal better and with less treatment than a similar break in an adult. But some fractures that look simple to treat can cause serious problems for children or teens and affect the ability of the bone to grow.

Growth Plates Injuries

In every child’s and teen’s bones, growth occurs at specific points called growth centers or growth plates — found near the ends of the bone. If the growth plate becomes damaged by a fracture or another injury, the bone may stop growing — growth arrest. Growth arrest can permanently stop a bone’s development and change how it functions. If only part of the growth plate becomes damaged and stops working, the bone may grow unevenly.

Our physicians at Medical City Children’s Orthopedic and Spine Specialists have the experience and expertise in the treatment of hand fractures. Our board-certified physicians specialize in the treatment of children and adolescents and can give your child the care and attention they deserve at one of our four locations in the DFW area.

Symptoms of Hand Injuries

Some symptoms of hand injuries are clear, for instance, when the bone in the hand breaks through the skin. Other broken hand symptoms include:

• Swelling, bruising, and bleeding
• Severe pain
• Bone or joint with the wrong shape
• Poor range of motion in the affected area
• Inability to move the affected part

When to Seek Medical Care

If a child has a hand injury, seek medical attention as soon as possible to prevent complications. The injury can become more devastating as medical care is delayed. Even a seemingly innocent hand injury could need advanced treatment to prevent being infected or loss of function.

Any form of a laceration that needs stitches requires a medical evaluation. If you are not sure if the cut your child sustained needs stitching, get in touch with one of our doctors for guidance.

Hand injuries that cause the following symptoms require emergency medical care:

• Numbness
• Severe bleeding
• Severe pain
• Loss of strength or motion
• Tenderness, redness, local warmth, fever, pus, or any other signs of infection
• Deformity or amputation
• Exposure of the tendons, bones, joints, veins, arteries, or nerves

Diagnosis

To detect hand injuries, doctors begin with an examination of the child. While examining the child, the doctor will check how the bones line up as the child moves the hand (provided they can) and when the doctor tries to move it (if the child cannot move the hand). The doctor will look for damages to the fingernail, ligaments, tissue under the nail, tendons, or joints.

If at least one bone appears broken, the doctor will request X-rays to know the actual type of treatment to provide. In most cases, the child will require X-rays from 3 angles to enable the doctor to closely observe the fracture or fractures.

Diagnosing Complex Hand Fractures

For a doctor to correctly diagnose a hand injury takes skill that eccomposes years of of experience.  Simple fractures can normally get treated with a cast or splint. On the other hand, complex fractures may require surgery. The ability for a doctor to determine when a child’s broken hand requires surgery takes special training and expertise with pediatric trauma. Our doctors at Medical City Children’s Orthopedic and Spine Specialists have the knowledge, skills and abilities to make the correct decisions regarding surgery.

If the bone breaks at or near a growth plate, it can injure the growth plate. Because the growth plate does not appear on an X-ray (although some signs of damage can be seen), the doctor may request a magnetic resonance imaging (MRI) scan to determine injury to the growth plate.

Treatment

The hand injury treatment that we provide for your child will depend on the fractured bone and the types of hand fractures sustained. The factors that determine the type of treatment to provide include:

• Stability of the bone (whether the fractured bone is stable or easily moves out of place)
• The alignment of the bone (whether the bone is properly aligned or out of position)
• The age of the child (the child’s growth stage affects how the bone heals)

Treatment of Broken Hand

It is better not to do more or less than what is required to get the desired results. In most cases, children’s hand injuries heal perfectly with casting or splinting. However, it should be noted that hand fractures heal differently in kids than in adults.

Application of Buddy Tape, Splint, or Cast

If the child’s X-ray reveals a fracture but the bone remains aligned, the child may require a splint so that the bone keeps its place while healing. In some hand fractures, buddy taping takes place. In this case, two fingers are taped together to prevent the affected part of the bone from moving too much.

A splint or buddy taping may provide the solution to allow the bone to heal. Depending on the bone that was fractured and the severity of the break, doctors may apply a cast when the swelling goes down. A cast is usually applied if it is suspected that the fractured bone may not heal unless it is kept in one position.

Our specialists also use casts because they make the child feel more comfortable since the broken hand and wrist are kept still. Also, this makes the child feel less pain whenever the affected area gets moved or bumped.

Fracture Reduction

If the X-ray reveals that the fractured bone occurs in a bad position, the doctor will try to perform fracture reduction (which involves trying to move the bone back into position) before applying a splint, tape, or cast. For instance, this can occur by the doctor moving the child’s finger or hand (closed reduction). Before carrying out this procedure, we give the child anesthesia or q sedative.

Surgical Treatment

If the doctor cannot perform a closed reduction, they will consider surgery. Our surgeon will make a small incision to see the fracture and move the fractured bone (open reduction). We may also use pins to keep the affected bone in place so that it can heal properly. Also, we may also use plates and screws to reposition the bone fragments into their normal alignment. These will be removed when the child comes for a clinic visit.

Most children with hand injuries do not need surgical treatment. If your child needs surgery, our specialists will ensure that he or she gets the appropriate surgery for his or her injury.

Medical City Children’s Orthopedic and Spine Specialists Provides Children and Teenagers Relief from Hand Injuries

At Medical City Children’s Orthopedic and Spine Specialists, we understand the growing bones in children and teenagers. We are adept at providing the appropriate hand fracture care, including surgery for the most complicated injuries.

Finally, we treat thousands of children and teens every year at our offices in  Arlington, Dallas, Frisco, and McKinney. Contact us today to learn more about our hand injury treatment options, which cater to hand fractures and growth plate injuries.