Pediatric Hand and Wrist Fractures

Pediatric hand and wrist fractures are common. Distal fractures like Seymour fractures and phalangeal neck fractures occur more commonly in younger patients and are unique to the pediatric population. Proximal fractures like metacarpal fractures tend to occur in teenage years, with increasing body weight and participation in sporting activities, and have more resemblance to adult fractures. Understanding of the physeal anatomy and carpal ossification is important in the accurate diagnosis of pediatric fractures. Consideration of the physeal biology and compliance with treatment are central to the management of these fractures. A majority have a favorable outcome with nonoperative treatment. Operative treatment should be considered in patients with clinical malrotation and scissoring, open fractures, and significant fracture displacement. Physeal-friendly surgical approaches and implants should be used to minimize the sequelae of physeal injury.