Pediatric clinics of North America
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Three pediatric hand injury subtypes and their management have been presented. Finger tip injuries, while often minor and self-healing in children, may require surgical repair if the nailbed is disrupted or if there has been significant skin or pad loss from the tip. The decision between local repair and skin graft or pedicle reconstruction depends on the nature and extent of the injury. ⋯ Immediate closure of all wounds, while desirable, is not necessary. Minor hand burns are quite easily managed but burn injuries more severe in extent and/or depth must be treated with careful attention to detail. Splinting and elevation of the hand, early incisional decompression, the institution of early and diligent active motion and expeditious wound closure with skin grafts where full thickness loss has occurred will hasten the time of healing, minimize deformity and assist in the recovery of normal hand function.