PEDIATRIC HAND PHALANGEAL FRACTURES

This chapter provides a comprehensive overview of the diagnosis and management of pediatric pha-langeal fractures, which are frequently encountered in children due to their explorative interaction with the environment. Distal phalanx fractures commonly occur in toddlers as a result of crush injuries, whereas older children involved in contact sports are more prone to diaphyseal and intra-articular fractures. The flexible and highly vascular pediatric periosteum facilitates rapid healing and substantial remodeling potential. However, open growth plates increase the risk of deformity and malunion if treatment is delayed or improperly conducted. A thorough history, careful physical examination, and appropriate radiographic imaging—including neurovascular assessment and evaluation of nail and soft tissue integrity—are crucial for accurate diagnosis. Treatment strategies vary according to fracture type, degree of displacement, and articular involvement. While distal phalanx fractures often respond well to conservative measures, certain conditions, such as Seymour fractures, require surgical debride-ment and reduction due to their open fracture characteristics. Bony mallet injuries typically heal with conservative management, but surgery may be indicated when a large portion of the articular surface is involved. Phalangeal neck, condylar, and shaft fractures, with their associated risks of deformity, rotation, and joint compromise, often necessitate more meticulous follow-up and surgical stabilization. In conclusion, early diagnosis, proper reduction, and treatment decisions that account for the child’s growth potential are vital in managing pediatric finger fractures. Given the limited prospective data on soft tissue injuries, further research is warranted to optimize treatment outcomes in this area.