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Hand Trauma

It’s easy to take the hands and wrists for granted—until one of them isn’t working properly.

When a child has a hand injury, the tendons, ligaments, muscles, bones, or joints that make up her hands and wrists may stop functioning correctly. This type of injury can affect how well he can use his hands, and can have a negative impact on his everyday quality of life.

Types

There are several types of hand injuries.

Some are from traumas—single events like a car accident or a fall. These events can result in an immediate injury, like a fractures (broken bone) or dislocation (bone moved out of place).

Other injuries develop over time, from overuse or repeated injuries that weaken the parts of the hand. These injuries may include:

  • Carpal tunnel syndrome: The nerves and tendons in the carpal tunnel—the passageway of bones and ligaments at the base of the hand—thicken or swell. The nerves become compressed, making it difficult for a child to perform tasks like grabbing an object.   
  • Tendonitis: Tendons are bands of tissue that bind muscles to bones and help them move. Tendonitis occurs when a child’s tendon or sheath—the layer covering the tendon—becomes irritated or inflamed.
  • Osteoarthritis: Cartilage is a tissue that covers the ends of the bones in a joint and absorbs shock, protecting the joint from injury. Osteoarthritis breaks down cartilage, damaging the joint and causing swelling, pain, or limited movement. Although osteoarthritis is the most common form of arthritis, it’s rarely found in children since it can take years to develop.

 

Causes

Traumatic injuries come a single event, like a sports injury or a fall.

If a child fractures his wrist or finger from a fall, he’s in good company—these are some of the most common fractures in children. That’s because when a child falls, he may throw his hands out to break the fall, putting an extreme amount of force and pressure on the hand or wrist.

Injuries that stem from overuse are often found in young athletes who perform repetitive motions, like pitching or swinging. Many times, these injuries are named after the sport that caused them (e.g., tennis elbow, golfer’s elbow, jumper’s knee).

Diagnosis

A diagnosis begins with a physical exam. The physician will look at the injury, and may perform small tests like pushing lightly on the area. He may then order imaging tests like X-rays or computed tomography (CT) scans to get a better understanding of the injury.

If there is a lot of swelling, the physician might take a fluid sample to make sure there isn’t an infection.

Treatment

OIC provides several types of treatment, and each treatment plan is individually tailored to a child’s specific needs.

Types of treatment may include:

  • A splint to keep the hand or wrist in place
  • Strengthening or stretching exercises
  • Light massage
  • Pain medication

 

Occasionally, a hand or wrist injury like a fracture may require surgery to set the bones back in place.

Prevention

While some injuries are unavoidable, a child can take steps to decrease his risk of an injury:

  • Take frequent breaks when using the hand or wrist repetitively.
  • Begin new tasks that involve the hand or wrist slowly.
  • Make adjustments to sports technique, like switching to a two-handed backhand in tennis.
  • Wear protective sports gear like wrist pads.
  • Keep wrists in a straight position—not bent up or down—when typing on a keyboard.

The OIC Hand Trauma Team

If your child or family member is referred to OIC’s for cerebral palsy, you can expect your team to consist of the following:

The Pediatric Orthopaedist specializes in the musculoskeletal system of children. They manage the problems associated with spasticity and provide surgical interventions when necessary such as tendon lengthening or correcting a bony deformity.

The Pediatrician reviews medical issues and coordinates the general healthcare of the patient, in addition to working with the orthopaedic surgeon for pre-operative assessments if surgery is indicated and overseeing medical issues for hospitalized patients.

The Physical Therapist is a health care professional trained to assess and treat movement and function. They examine muscle range of motion, spasticity, strength and posture and assess their impact on function and mobility. Our physical therapists communicate with community therapists to help design and implement treatment interventions and equipment such as wheelchairs and braces. Gait studies at the Kameron Gait and Motion Analysis Laboratory are conducted by physical therapists.

The Nurse Specialist assists in making sure all medical orders are carried out, and provides case management and nursing assessment for the patient.