Aims of the study
Conventional radiography is frequently performed in pediatric patients in whom finger fractures are suspected. However, until now, the rate of positive findings of finger radiographic examinations in pediatric population hasn’t much been described. This study aimed to evaluate the number of positive findings of standard radiographic examinations for finger injuries among pediatric patients in a level 1 trauma center.
Methods
We conducted a retrospective study including all children 0-16 years old admitted for acute finger injury in the Emergency Department of Lausanne during the first semester of 2019 who received a radiographic examination. Demographic characteristics, fracture pattern, and treatment administered were collected retrospectively from the clinical notes and the radiographic examinations stored in the institutional PACS system.
Results
Out of 478 finger injuries reviewed in this cohort, 160 X-rays were positive for fractures giving a fracture rate of 33,5%. Nearly half of them (51,9%) occurred in the age group of adolescents (11-16 years), with a peak incidence at 12 years old. The male to female ratio of fractures was of 1,7. However, in the younger age group, girls were more prone to present a fracture than boys. Extra- articular fractures were the most common type of fracture. Finally, among all finger fractures, only 3,8% of them were treated surgically.
Conclusions
Our study highlights a relevant amount of standard finger radiographs with a fracture rate similar to other studies. There was also quite a high rate of conservative treatment and a very low need of surgical treatment. Therefore, indications for X-rays could be reviewed and alternative procedures should be taken into consideration. Clinical decision algorithms should be developed, and clinical care pathways have to be implemented in order to minimize radiation exposure, emergency room waiting times and costs.