UPPER EXTREMITY CHILDREN’S FRACTURES – EPIDEMIOLOGY, HEALING MECHANISM, CLASSIFICATION AND TREATMENT CHALLENGES

Children’s fractures account for almost 25% of all pediatric disorders, making them a significant public health concern. In this review, we will focus on upper extremity fractures in children, which account for approximately 65% of all fractures in this population. Sports, education, and recreation can all be impacted by fractures. Expert-guided and carefully directed rehabilitation is required to attain the upper extremity’s physiological range of motion and functionality while preventing potential long-term complications such as deformity, peripheral nerve injuries, and, less commonly, impaired bone growth. The aim of this review is to provide an overview of pediatric upper extremity fractures, focusing on their complexity, epidemiology, healing mechanisms, classification, treatment challenges, the significance of peripheral nerve injuries and associated psychological manifestations. We searched scientific databases such as Google Scholar, Pubmed, and Web of Science. Original research articles, book chapters, systematic reviews, and meta-analyses were selected using the terms: fracture, classification, peripheral nerve lesion, surgery, and rehabilitation in combination with upper extremity and children predominantly in the period within last five years. Pediatric fractures differ from adult fractures due to specific bone structure, higher potential for growth and regeneration, physical activity patterns, and bone mineralization. There are no standardized guidelines or protocols regarding surgical management and rehabilitation following a fracture. Hospitalization, immobilization, and rehabilitation can have an impact on social life, and long-term immobilization might lead to psychological issues. The most common causes of fractures in children include falls during climbing and fractures sustained in contact sports. Decision regarding treatment modality should consider the child’s age, the type of fracture, potential peripheral nerve involvement, and participation in sports activities. In addition, attention should be given to the psychological impact of fractures.