O2109: Pediatric Thumb Proximal Phalangeal Fractures: Epidemiology, Outcomes, and Complications

Background: Hand fractures are the most common fractures in the pediatric population. Previous literature has evaluated proximal phalangeal thumb fractures in adult populations, but the literature surrounding pediatric thumb proximal phalangeal fractures is limited. The purpose of this study is to describe the epidemiology, treatment, and outcomes of pediatric thumb proximal phalangeal fractures.

Methods: A retrospective review was performed of pediatric and adolescent patients treated for a thumb proximal phalangeal fracture over a 13-year period. Patient demographics, mechanisms of injury, fracture pattern, immobilization type, immobilization length, length of follow-up, patient outcomes, and complications were recorded. Simple statistical analysis was performed.

Results: 14 patients with an average age of 9.9 years (SD: 4.5 years) were identified. 78.6% of patients were male. The most common mechanism of injury was sports participation (N=7), followed by a jammed finger (N=2), and a fall (N=2). The average time from initial injury to evaluation was 5.6 days (SD: 3.3 days). The most common fracture type was a Salter Harris fracture (N=6), followed by a shaft fracture (N=3). One (7.1%) patient had a concomitant injury of a soft tissue calcification. 10 (71.4%) patients were treated nonoperatively with immobilization in a short arm thumb spica cast for an average of 19.8 days (4.7 days). Four (2.9%) patients were treated operatively with a closed reduction and percutaneous pinning. The average time from initial evaluation to surgery was 3.5 days (SD: 2.2 days). 75% (N=3) of patients had 2 pins placed across the fracture site, while 25% (N=1) of patients had 3 pins placed across the fracture site. Following the procedure, patients were immobilized on average of 27.8 days (SD: 2.5 days). The average time from surgery to removal of hardware was 27.8 days (SD: 2.5 days). There were no complications reported. The average time to return to activity was 37 days (14.5 days)

Conclusion: Pediatric thumb proximal phalangeal fractures can be successfully managed with minimal complications. Further study with a larger sample size assessing thumb proximal phalangeal fractures in the pediatric population, the surgical interventions utilized, and their outcomes is warranted.