Zusammenfassung
Hintergrund
Die Hand ist die zweithäufigste Verletzungsregion bei Kindern. Ziel dieser Studie war die Darstellung der altersabhängigen Verletzungsart, des Traumamechanismus und der Operationsnotwendigkeit bei Verletzungen der Hand bei Kindern.
Patienten und Methoden
Retrospektive Studie mit Datenerhebung von 01/2008 bis 12/2014 am Universitätsklinikum Frankfurt am Main. Alle Patienten, die eingeschlossen wurden, waren jünger als 18 Jahre und hatten eine Verletzung an der Hand oder den Fingern. Traumamechanismus, Art der Verletzung und Operationsnotwendigkeit wurden abhängig von verschiedenen Altersgruppen (0–3 Jahre, 4–7 Jahre, 8–12 Jahre und 13–17 Jahre) untersucht. Relevante Verletzungen waren Frakturen, Luxationen, Amputationen und Verletzungen der Sehnen und Nerven. Leichte Verletzungen waren Prellungen und oberflächliche Wunden.
Ergebnisse
Insgesamt 2823 Patienten mit einer Hand- oder Fingerverletzung wurden eingeschlossen (61,5 % männlich, Median des Alters 10,3 Jahre). 60,4 % aller Verletzungen waren an den Fingern und 39,6 % an der Hand lokalisiert. Relevante Verletzungen waren bei 703 Patienten (24,9 %) und leichte Verletzungen bei 2120 Patienten (75,1 %) zu finden. 74,8 % aller relevanten Verletzungen waren Frakturen, gefolgt von 9,4 % mit Luxationen und 7 % mit Amputationen. Hauptursache für relevante Verletzungen waren Sportverletzungen (24,2 %), gefolgt von Einklemmungen (17,9 %) und Stürzen (14,7 %). Insgesamt wurden 436 Patienten (15,5 %) operiert, wobei 9,4 % im Operationssaal und 6,1 % in der Notaufnahme versorgt wurden.
Schlussfolgerung
Fast 75 % aller Kinder, welche sich in der Notaufnahme nach einem Trauma der Hand oder der Finger vorstellten, erlitten leichte Verletzungen. Jedoch hatten 25 % eine relevante Verletzung. 15,5 % aller Kinder mussten operiert werden. Die häufigste Verletzung an der Hand und den Fingern ist die Fraktur.
Abstract
Background
The hand is the second most frequently injured region of the body in children. The aim of this study was to evaluate age-related injury patterns, trauma mechanisms, as well as the need for surgery in pediatric patients with injuries to the hand.
Patients and methods
This was a retrospective study analyzing the data between January 2008 and December 2014 at Frankfurt University Hospital. All patients were younger than 18 years old. All patients suffering trauma to the hand or the fingers were included. The injury mechanism, injury pattern as well as need for surgery were analyzed according to different age groups (0–3 years, 4–7 years, 8–12 years and 13–17 years). Major injuries were defined as fractures, dislocations, amputations and injuries of the tendons or nerves. Minor injuries included contusions and superficial wounds.
Results
Overall, 2823 emergency pediatric patients with an injury to the hand or fingers were included (61.5% male, median age 10.3 years). Of the injuries 60.4% were located on the fingers and 39.6% on the hand. Major injuries were found in 703 patients (24.9%) and minor injuries in 2120 patients (75.1%). Of those patients with a major injury, 74.8% suffered a fracture, 9.4% an injury of nerves and tendons and 7.0% an amputation. The most common trauma mechanism for major injuries was sports (24.2%), followed by crushing (17.9%) and falls (14.7%). Overall, 436 patients (15.5%) were surgically treated of which 9.4% were operated on in the operation room and 6.1% in the emergency room.
Conclusion
Almost 75% of all children who presented to the emergency department following trauma to the fingers or the hand revealed minor injuries; however, 25% suffered a relevant, major injury. Overall, 15.5% had to be surgically treated. The most frequently found major injuries were fractures of the hand and the fingers.
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M. Voth, T. Lustenberger, J. Frank und I. Marzi geben an, dass kein Interessenkonflikt besteht.
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Voth, M., Lustenberger, T., Frank, J. et al. Finger- und Handverletzungen bei Kindern. Chirurg 88, 871–878 (2017). https://doi.org/10.1007/s00104-017-0499-8
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DOI: https://doi.org/10.1007/s00104-017-0499-8