Wrist and Hand Injuries

From little fingers getting stuck in doors, to bigger fingers being bent back by baseballs, the hand and wrist are frequent sites both for acute injuries as well as overuse problems. If your child has an injury, contact Children's Ortho today to get dedicated pediatric treatment for your child.

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Hand & Wrist Anatomy

The hand and wrist are made up of many bones. 

Phalanges: Better known as the fingers, or digits. There are typically five digits, although many people can be born with 4 or 6. Finger fractures and dislocation are extremely common, and more information will be discussed below. The thumb has two phalangeal bones (proximal and distal phalanx), while each of the other fingers have three phalangeal bones (proximal, middle, and distal phalanx). The finger nail is located on the distal phalanx.

Metacarpals: The metacarpal bones represent the middle portion of the hand in between the fingers (phalanges) and wrist. There are five metacarpal bones, as demonstrated in the diagram, and they are typically numbered 1-5, with 1 at the thumb and 5 at the pinky (aka small finger)

Carpal Bones: There are a total of 8 carpal bones. They are less frequently involved in acute injuries except for the scaphoid bone which is located between the thumb and the forearm.

Acute Wrist and Hand Injuries

 

Scaphoid Fracture

The scaphoid is the most commonly fractured carpal bone in children. Typically, it occurs as a result of a fall on an outstretched hand. While the wrist will typically not appear "crooked", it will be swollen, and your child will complain of pain at the base of the thumb. Read more.

TFCC Tear

The Triangular Fibrocartilage Complex (TFCC) is a soft tissue complex located on the ulnar (pinky side) of the wrist that is involved with stabilizing the wrist joint. The TFCC is located between the carpal bones and the tip of the ulna bone (known as the ulnar styloid).  Read more.

Thumb Fracture

A broken thumb usually presents with pain, swelling and/or bruising in the area. Radiographs are used to confirm the diagnosis. Treatment involves either setting the thumb or merely immobilizing it with casting. Healing typically takes around 6 weeks. Read more.

 

Metacarpal Fracture

Metacarpal fractures are characterized as articular (joint) vs extra-articular (not involving the joint) and by location (base, shaft, neck or head). Angular deformity ("crookedness") may be tolerated depending on which finger is involved. Read more.

Phalangeal (Phalanx) Fracture

Fractures of the phalanx (finger) typically involve the growth plate in children, which might impact the future length of the finger, but this is rare. Treatment of these fractures is very similar to a metacarpal fracture. Read more.

Finger Dislocations

Finger dislocations are relatively common in sports. Often times these injuries are reduced (put back into place) right there on the field. Even if it is put back into place on the field, you should consult with an orthopedic doctor to evaluate further. Read more.

Chronic Wrist and Hand Injuries


Ulnar Impaction Syndrome

Ulnar impaction is one of the many causes of ulnar (pinky-sided) wrist pain. It typically occurs secondary to excessive loading of the wrist. Read more.

Gymnast Wrist

As the name implies, "gymnast wrist" is an overuse injury to the growth area of the radius bone near the wrist. Read more.