Elsevier

Injury

Volume 31, Issue 8, October 2000, Pages 571-573
Injury

Isolated finger injuries in children — incidence and aetiology

https://doi.org/10.1016/S0020-1383(00)00052-8Get rights and content

Abstract

Details were recorded prospectively in a specifically designed questionnaire for all children presenting to the Accident and Emergency Department with isolated finger injuries over a period of 6 months, in order to understand the incidence and aetiology. Among the 426 injuries in 283 children, most occurred at home (59%) more in the <5 year age group (38%), involving the middle finger (25%) and terminal phalanges (47%). “Jamming/crushing” was the commonest reason (48%), mostly caused by a child (59%) at the living room door (32%) and more commonly at the hinge side (49%). Nail injuries were seen in 48% of cases and 16 amputations of terminal phalanges were noticed in 15 children. Tendon injuries were only caused when cut by sharp objects, and were not caused by jamming/crushing. Both children and adults should be educated about causation, reiterating that damage to fingers can be prevented or reduced by observing safety measures.

Introduction

Fingers are amongst the most mobile and active parts of the body in children when they are awake. When fingers are injured daily activities like eating, playing and schoolwork are either not possible or restricted. Parents are anxious about such immediate problems, as well as long term functional disability and appearance. It is important, therefore, to understand the incidence and causes of finger injuries.

Section snippets

Patients and methods

In a prospective study over 6 months, 283 children were included. A specially designed questionnaire was completed by the examining medical practitioners, about the injuries in the children aged less than 14 years presenting with isolated finger injuries (IFI), with or without metacarpal injuries. If there were additional injuries elsewhere in the hand or body, they were excluded from the study. Bites and thermal injures were also excluded. Radiological investigations were performed in all

Results

There were 11 IFI per week — 1.8% of the attendees in the Accident and Emergency Department. Two hundred and eight (74%) children presented on the day of injury, 35 (12%) the day after and the remainder more than 2 days after this, the latest being 22 days. The incidence was highest in the younger children and more were boys (Table 1). The right hand was injured in slightly more children — 153 (54%) compared to 130 (46%) on the left. Most injuries occurred at home (Table 2), in the middle

Discussion

Although IFI are not life threatening they are sources of pain for children and of psychological trauma for children and child carers, because of interference with daily activities, like eating, playing and school work, and anxiety about recovery of function, possible disability and shortening of fingers.

The prevalence of IFI in Glasgow and Scotland is not known. The true incidence of IFI will be unknown as children are also treated in other hospitals in the city as well as by general

Conclusion

IFI commonly occurs at home, due to jamming in doors, often closed by a child, resulting in cuts of soft tissue, nail or bony injuries, including amputation. Tendons are cut with sharp objects only and not by jamming. Both children and adults should be educated about the mechanism and causation, reiterating that damage to the fingers can be prevented or minimised by the use of safety measures. Education should be aimed at the children in schools, and in the waiting halls of general practice

Acknowledgements

We would like to thank Mrs Claire Donati for secretarial assistance, Miss Jean Hyslop for the illustrations and the senior house officers, patients and parents who have participated in the study.

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