Paediatric Hand Injuries

Injuries to the hand are frequent in children and teenagers. Crush damage from a hand trapped in a closing door is the most prevalent mechanism of injury in younger children, whereas recreational activities cause most fractures in teens. Hand fractures account for ten percent of all fractures. Phalangeal fractures are the most common type of hand fracture in adolescents.


A physical examination and X-rays will aid the diagnosis of hand and wrist injuries. X-rays may reveal indications of uneven bone margins or radial growth plate expansion. If the kid does not have symptoms in both wrists, comparison X-rays might be useful.

Common Hand and Wrist Injuries in Children

Broken bones, commonly known as fractures, are among the most common injuries to the hand and wrist in children. Children are not to be mistaken for little adults.
Compared to our bones, which grow increasingly dried-out and brittle as we age, their bones have a distinct consistency and texture, similar to soft, new wood. Because children are still growing, their injuries need a distinct assessment and, in some cases, treatment.

Wrist Injuries

The majority of wrist injuries in children occur during sports or play or as a result of falls. Any damage to the end of a long bone near a joint has the potential to harm the growth plate (physis) and should be examined.

Some of the commonly occurring wrist injuries in children include:

Gymnast Wrist

The growth plate (epiphysis) at the end of the radius (forearm bone), where it joins the hand to create the wrist, is irritated and inflamed in the gymnast’s wrist. The growth plate is made primarily of cartilage, which is softer than mature bone and more prone to damage.
Gymnast’s wrist is a common overuse injury among young gymnasts, affecting up to 40% of them. It often manifests itself during a period of increasing gymnastic exercise intensity, such as when a gymnast advances to a higher competitive level. Tumbling and vaulting, for example, place a significant amount of compressive strain on the wrist’s growth plate.

Wrist Sprains and Strains

When the strong ligaments that support the wrist strain or break, it results in a wrist sprain. This happens when the wrist is bent or twisted violently, as in a fall onto an extended hand. Sprains of the wrist are a common occurrence. They might range from moderate to severe, depending on the extent of ligament injury.
Wrist sprains are categorized according to the severity of the ligament injury:

  • A sprain of grade 1(mild) is a sprain that occurs when the ligaments have been stretched but have not been torn.
  • A sprain of grade 2(moderate) is a sprain that occurs when the ligaments have been partially ripped. Some functions may be lost as a result of this sort of damage.
  • A sprain of grade 3 (severe) is a sprain that occurs when the ligament is totally ripped or pushed away from its connection to the bone. These are serious injuries that need medical or surgical treatment. If the ligament breaks away from the bone, a tiny piece of bone may be left behind. An avulsion fracture is what this is termed.

Hand Injuries

The hand is an extraordinary feat of anatomic engineering, both in design and function. In the hand, form follows function; hence, any injury to the underlying structures of the hand has the potential to cause significant disability.

Some of the commonly occurring injuries in the hand include:

Thumb/Finger Dislocation

A common hand injury is finger dislocation. When the bones of the finger are dislocated from their natural position, it causes pain and swelling. A dislocated finger can occur in any of the joints of any finger, although it is most often in the little ring, middle, or index finger’s middle knuckle.
A dislocated finger is produced by a “jamming” force exerted to the end of the finger or by the finger being overextended forcibly. A dislocation can occur in one of these conditions or a combination of both.

Mallet Finger

A frequent sports injury among teenagers is the mallet finger. Mallet finger is a condition in which the end of your finger bends inwards towards your palm.
Your finger will also be swollen and uncomfortable. Because the tendon linking the muscle to the finger bone is sprained or ripped, you won’t be able to straighten the end of your finger.

Broken Thumb

The phalanges are the two bones that make up your thumb. The most common fracture linked with a fractured thumb is the first metacarpal, the largest bone in your hand. This bone links to the bones of your thumb.
The first metacarpal begins at the webbing between your thumb and index finger and runs back to your wrist’s carpal bones.
The carpometacarpal (CMC) joint is where the first metacarpal connects to your wrist. The base of the first metacarpal, right above the CMC joint, is where most thumb bone fractures and metacarpal fractures occur.

Sprained Thumb

When the tissues in your thumb that link the bones of a joint are injured, you get a thumb sprain. Ligaments are the tissues that maintain your bones in place while the joint moves. Several ligaments in your thumb assist you in grasping items, pinching, and making a fist.
Because the ligament or bone is not fractured or torn, a thumb sprain is far less severe than a broken thumb. A torn ligament or a shattered bone may necessitate more long-term therapy.

Fingertip Injuries

Family and emergency physicians frequently witness fingertip injuries. Many of the situations are straightforward and do not necessitate the services of a hand surgeon. However, early intervention by a hand surgeon is necessary for improved functional and cosmetic outcomes in some cases.
Finger injuries, crush injuries to the fingertip with a hematoma, nail bed laceration, partial or full amputation of the fingers, pulp amputations, and distal phalangeal fractures are common injuries.

Hand & Wrist Fractures in Children

The most common fractured bones in the arm are wrist fractures. The radius and ulna, which are two forearm bones, and the scaphoid, lunate, and triquetrum, which are three smaller carpal bones in the hand, can all be fractured in the wrist.
The most frequent wrist fracture in children is distal radius fracture, which occurs when the radius (the forearm’s bigger bone) is shattered near the wrist. When a youngster falls on an outstretched hand that is extended backwards, this happens frequently.
The severity of your child’s wrist fracture, as well as the required treatment and recovery time, will be determined by the type of wrist fracture they have.
A splint or cast is the most frequent treatment for broken fingers, wrists, and hands in children. If the fractured bone is not aligned, a physician may need to manually manipulate the bone to “set” or “reduce” it in an emergency department. Surgery to reset the fracture and implant a metal plate, screws, pins, or rods to maintain the bone in a normal position while it heals may be required in more severe fractures.

Tendon Injury

The strong strands that link muscle to bone are known as tendons. The majority of tendon injuries happen around joints like the shoulder, elbow, knee, and ankle. A tendon injury may appear to occur abruptly, but it is generally the consequence of a series of small rips in the tendon that has occurred over time.
A doctor will ask questions about your prior health and symptoms and do a physical examination to diagnose a tendon injury. If your injury is caused by how you use a tool or piece of sporting equipment, the doctor may ask you to demonstrate how you use it.
Your doctor may order a test such as an X-ray, ultrasound, or MRI if your symptoms are severe or do not improve with physical therapy.


Heat, overexposure to the sun or other radiation, or chemical or electrical contact can cause tissue injury. Burns can range from minor medical issues to life-threatening situations.
Burn therapy is determined by the location and degree of the injury. Parents may typically cure small scalds and sunburns at home. Burns that are deep or extensive require prompt medical treatment. Some patients require treatment at specialist burn facilities as well as months of follow-up.

Congenital Hand Conditions

Congenital hand problems are prevalent, with at least 2.3 per 1,000 newborns being affected. Many of these ailments are mild and have little impact on one’s ability to operate. They may, however, be observed by parents and others who seek guidance from doctors.
Polydactyly (additional fingers) and syndactyly (joined fingers) are two of the most frequent congenital hand abnormalities. The majority of children with these disorders do not have any additional health issues.
Parents frequently worry about why their child’s hand isn’t normal. The majority of the time, healthcare practitioners are unable to determine what caused a congenital hand disease. The mother’s actions or inactions during pregnancy are seldom the sources of these hand abnormalities.