A small number of children are born with congenital hand conditions. A lot more will suffer various hand injuries that may need hospital treatment.
Congenital Hand Conditions
Polydactyly and Syndactyly
About two in 1,000 babies are born with hand anomalies, and the most commonly treated conditions are extra fingers (polydactyly) and joined fingers (syndactyly). Such anomalies can escape detection during ultrasound tests, but many of these conditions are minor and do not affect the child’s use of his hands.
Treatment options vary according to the extent of the anomaly, and the goal is to help children gain optimum use of their hands. Some may require surgery, but at National University Hospital (NUH), for example, the focus is usually on improving the function of the hand rather than its appearance. Non-invasive treatments include stretching exercises and splinting (similar to casting, where the hand is immobilised), which may correct mild conditions or improve hand dexterity.
Hand Injuries
Hand Fractures
Hand fractures are the most common injuries sustained by children and these are diagnosed through an X-ray. Schoolchildren who play sports are more likely to sustain fractures than those who don’t, but most paediatric hand fractures heal completely. Treatment may involve using a splint or cast to immobilise the hand, while in some cases, surgery is needed to help the bone heal.
Fingertip Injuries
Fingertip injuries are also common, and treatment may involve cleaning the wound and removing the fingernail, followed by a course of antibiotics or an injection to prevent infection. An NUH study of child patients with fingertip injuries from 2008 to 2011 found that 50 percent also had to be treated for associated fractures. Children aged two were also found to be more likely to sustain fingertip injuries than other age groups.
Most fingertip injuries seen at NUH are crush injuries, with door-related accidents being the most common cause. In severe cases, accidents can lead to amputation of the fingertip. The priority of treatment is to preserve the amputated part and see if reattachment is possible; if not, reconstruction surgery may be needed.
Safety education is therefore extremely important. Door stoppers placed near the lock or at the base of the door and plastic hinge protectors are simple items that may prevent such accidents. Whether the injury is minor or serious, consult a doctor as soon as possible so it can be evaluated and referred promptly for specialist treatment if necessary.
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