Hand Fractures

Pediatric hand and finger fractures require systematic evaluation of history, biomechanics, and precise radiographic imaging. Scaphoid fractures demand high clinical suspicion due to tenuous blood supply and significant non-union risks; localized snuff box tenderness necessitates immobilization and specialist follow-up even when initial radiographs appear normal. Metacarpal fractures, particularly those involving the fifth metacarpal, require careful assessment for rotational deformity and angulation, with specific thresholds determining the need for closed reduction or surgical intervention. Distal phalangeal injuries, especially Seymour fractures involving the nail bed and physis, represent high-risk cases requiring urgent debridement to prevent growth arrest and mallet deformities. Throughout the diagnostic process, identifying rotational misalignment—often manifested as scissoring—remains critical for determining whether conservative splinting or operative management is necessary to preserve long-term hand function.