Current Concept Review: Management of Pediatric Hand Injuries in the Acute Setting Part 2: Fractures and Dislocations,

This is the second article in a three-part series on the acute care of pediatric hand injuries. The first article covered what defines a pediatric hand injury, general principles, when to refer a child to a pediatric hand surgeon, and an overview of immobilizing the pediatric hand and upper extremity. For a detailed collection on the technical aspects of pediatric splint and cast application, the reader is referred to the JPOSNA Primer on Cast and Splint Application. https://www.jposna.com/content/jposna_ae_primer_on_cast_and_splint_application This section will discuss the principles of diagnosis and immediate management for specific fractures and dislocations. Expert opinions were consulted to supplement this review. • Phalanx fractures are among the most common upper extremity fractures in children. Treatment varies based on the fracture's location within the phalanx. • Radiographs of the finger (including thumb) and clinical functional exam, including evaluation of the involved finger in flexion, are necessary to determine appropriate treatment. • Immediate management at time of injury can often be definitive treatment of the presenting injury. • Detailed management is described for the most common finger, hand, and carpal fractures. • Follow up with a hand specialist within one week of injury will ensure proper treatment of pediatric hand fractures.