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Pediatric hand injuries: Practical approach for primary care physicians.

OBJECTIVE: To present a practical and evidence-based approach for primary care physicians to the diagnosis and initial management of common pediatric hand injuries, and to identify injuries requiring prompt referral.

SOURCES OF INFORMATION: Clinical evidence and expert recommendations were identified by using MEDLINE and EMBASE for each topic presented.

MAIN MESSAGE: Pediatric hand injuries are a common reason for physician consultation. The most common and potentially problematic pediatric hand injuries include fingertip injuries, phalangeal fractures, tendon injuries, and hand burns. Management is limited by difficulties in proper assessment of the hand and the paucity of evidence to guide treatment. Nevertheless, outcomes in children are typically excellent.

CONCLUSION: Appropriate assessment, initial management, and, if necessary, timely referral of pediatric patients with hand injuries are paramount given the importance of the hand in function and child development. While some principles from managing adult hand injuries might apply, children often require special considerations.

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