Isolated finger injuries in children — incidence and aetiology
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.
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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.
References (4)
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