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Hand Dislocations in Children

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The Pediatric Upper Extremity

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Abstract

Finger dislocations are common injuries. They frequently occur in the pediatric athletic population and are often reduced by athletic trainers. Typically, they are simple dislocations that are easily reducible, but some need operative intervention to achieve reduction. The metacarpophalangeal joint requires open reduction more frequently than the interphalangeal joints.

There are several structures specific to each joint that can impede a stable reduction, which is essential to proper long-term function of the digit and the hand as a whole. Proper knowledge of both closed and open methods of joint reduction is essential for orthopedists and hand surgeons alike.

Today, children are being encouraged or even pushed to pursue sports at higher and higher levels at younger and younger ages. As a result, adult-type injury patterns have become more common in the pediatric population. Pediatric-specific injuries included physeal injuries and ligamentous avulsions. Ligamentous injuries in children usually present as avulsion injuries rather than midsubstance tears. In very young children with incompletely ossified epiphyses and carpal bones, avulsions may be purely cartilaginous, making simple X-ray diagnosis impossible. Radiographs weeks to years later may reveal the true extent of the injury as the cartilaginous avulsion ossifies. There is a tendency to undertreat injuries in children; however, joint dislocations, subluxations, and ligamentous injuries do not remodel. These ligamentous and soft tissue attachments are necessary and may help guide bony remodeling. The loss of these stabilizing structures can lead to progressive deformity as the child grows.

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Acknowledgments

The authors wish to recognize the work of previous authors Rey Ramirez, Raymond Metz, Patrick Emerson, MD, and colleagues for their contributions to The Pediatric Upper Extremity and to this manuscript.

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Authors and Affiliations

  1. Hand, Microsurgery and Reconstructive Orthopedics, Erie, PA, USA

    John Lubahn

  2. Department of Orthopedic Surgery, Akron Children’s Hospital, Akron, OH, USA

    Stephanie A. Russo

  3. Plastic and Reconstructive Surgery, VCU health, Richmond, VA, USA

    Ja Hea Gu

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  1. John Lubahn
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  2. Ja Hea Gu
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  3. Stephanie A. Russo
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Correspondence to John Lubahn .

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Editors and Affiliations

  1. Dept. of Orthopedics, U. of Maryland School of Medicine, Timonium, MD, USA

    Joshua M. Abzug

  2. Shriners Hospital for Children - Phila., Philadelphia, PA, USA

    Scott Kozin

  3. Shriners Hospital For Children - Phila., Philadelphia, PA, USA

    Dan A. Zlotolow

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Lubahn, J., Gu, J.H., Russo, S.A. (2023). Hand Dislocations in Children. In: Abzug, J.M., Kozin, S., Zlotolow, D.A. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8758-6_46-2

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  1. Latest

    Hand Dislocations in Children
    Published:
    04 September 2023

    DOI: https://doi.org/10.1007/978-1-4614-8758-6_46-2

  2. Original

    Hand Dislocations
    Published:
    20 June 2014

    DOI: https://doi.org/10.1007/978-1-4614-8758-6_46-1

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