Abstract
This is the second article in a three-part series on the acute care of pediatric hand injuries. The first article covered what defines a pediatric hand injury, general principles, when to refer a child to a pediatric hand surgeon, and an overview of immobilizing the pediatric hand and upper extremity. For a detailed collection on the technical aspects of pediatric splint and cast application, the reader is referred to the JPOSNA Primer on Cast and Splint Application. https://www.jposna.com/content/jposna_ae_primer_on_cast_and_splint_application. This section will discuss the principles of diagnosis and immediate management for specific fractures and dislocations. Expert opinions were consulted to supplement this review. KEY CONCEPTS: (1)Phalanx fractures are among the most common upper extremity fractures in children. Treatment varies based on the fracture's location within the phalanx.(2)Radiographs of the finger (including thumb) and clinical functional exam, including evaluation of the involved finger in flexion, are necessary to determine appropriate treatment.(3)Immediate management at time of injury can often be definitive treatment of the presenting injury.(4)Detailed management is described for the most common finger, hand, and carpal fractures.(5)Follow-up with a hand specialist within 1 week of injury will ensure proper treatment of pediatric hand fractures.