Download PDF
Semin Musculoskelet Radiol 2024; 28(04): 424-436
DOI: 10.1055/s-0044-1779716
Review Article

Congenital and Traumatic Conditions of the Pediatric Hand: Overview for the Radiologist

J. Herman Kan 
1   Edward B. Singleton Department of Radiology, Division of Body Imaging, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
,
Olivia A. Barron
2   Department of Orthopaedics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
,
Bryce R. Bell
2   Department of Orthopaedics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Alignment, longitudinal growth, and function of the musculoskeletal unit of the pediatric hand is complex due to the combination of open growth plates, ossification variations, and their relationship with finger tendinous and ligamentous attachments. This review presents the basics of normal development, acquired and congenital variations, and traumatic conditions of the pediatric hand from the perspective of the pediatric musculoskeletal radiologist and hand surgeon. This multimodality imaging article focuses on non-oncologic and non-rheumatologic conditions of the pediatric hand, inclusive of fingers, thumb, and metacarpal bones.

Keywords

radiographs - ultrasonography - congenital hand deformities - traumatic hand deformities - bone age


Publication History

Article published online:
29 July 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Dibbs RP, Mitchell TW, Baumgartner RE, Koshy JC, Bell BR. Complication rates in patients with classic and radiographic variants of Seymour fracture. J Pediatr Orthop 2023; 43 (02) e157-e162
    CrossrefPubMedGoogle Scholar
  • 2 Nellans KW, Chung KC. Pediatric hand fractures. Hand Clin 2013; 29 (04) 569-578
    CrossrefPubMedGoogle Scholar
  • 3 Parker SE, Mai CT, Canfield MA. et al; National Birth Defects Prevention Network. Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004–2006. Birth Defects Res A Clin Mol Teratol 2010; 88 (12) 1008-1016
    CrossrefPubMedGoogle Scholar
  • 4 Goldfarb CA, Shaw N, Steffen JA, Wall LB. The prevalence of congenital hand and upper extremity anomalies based upon the New York Congenital Malformations Registry. J Pediatr Orthop 2017; 37 (02) 144-148
    CrossrefPubMedGoogle Scholar
  • 5 Laor T, Clarke JP, Yin H. Development of the long bones in the hands and feet of children: radiographic and MR imaging correlation. Pediatr Radiol 2016; 46 (04) 551-561 ; quiz 548–550
    CrossrefPubMedGoogle Scholar
  • 6 Laor T, Chun GFH, Dardzinski BJ, Bean JA, Witte DP. Posterior distal femoral and proximal tibial metaphyseal stripes at MR imaging in children and young adults. Radiology 2002; 224 (03) 669-674
    CrossrefPubMedGoogle Scholar
  • 7 Jaramillo D, Laor T, Zaleske DJ. Indirect trauma to the growth plate: results of MR imaging after epiphyseal and metaphyseal injury in rabbits. Radiology 1993; 187 (01) 171-178
    CrossrefPubMedGoogle Scholar
  • 8 Ecklund K, Jaramillo D. Patterns of premature physeal arrest: MR imaging of 111 children. AJR Am J Roentgenol 2002; 178 (04) 967-972
    CrossrefPubMedGoogle Scholar
  • 9 Miyamura S, Tanaka H, Oka K. et al. Physeal bar resection using a patient-specific guide with intramedullary endoscopic assistance for partial physeal arrest of the distal radius. Arch Orthop Trauma Surg 2018; 138 (08) 1179-1188
    CrossrefPubMedGoogle Scholar
  • 10 Greulich WW, Pyle SI. Radiographic Atlas of Skeletal Development of the Hand and Wrist. Redwood City, CA:: Stanford University Press;; 1959
    CrossrefGoogle Scholar
  • 11 Loder RT, Estle DT, Morrison K. et al. Applicability of the Greulich and Pyle skeletal age standards to black and white children of today. Am J Dis Child 1993; 147 (12) 1329-1333
    PubMedGoogle Scholar
  • 12 Yuh YS, Chou TY, Chow JC. Applicability of the Greulich and Pyle bone age standards to Taiwanese children: a Taipei experience. J Chin Med Assoc 2022; 85 (07) 767-773
    CrossrefPubMedGoogle Scholar
  • 13 Alshamrani K, Messina F, Offiah AC. Is the Greulich and Pyle atlas applicable to all ethnicities? A systematic review and meta-analysis. Eur Radiol 2019; 29 (06) 2910-2923
    CrossrefPubMedGoogle Scholar
  • 14 Mora S, Boechat MI, Pietka E, Huang HK, Gilsanz V. Skeletal age determinations in children of European and African descent: applicability of the Greulich and Pyle standards. Pediatr Res 2001; 50 (05) 624-628
    CrossrefPubMedGoogle Scholar
  • 15 Tanner J, Oshman D, Bahhage F, Healy M. Tanner-Whitehouse bone age reference values for North American children. J Pediatr 1997; 131 (1 Pt 1): 34-40
    CrossrefPubMedGoogle Scholar
  • 16 Reddy NE, Rayan JC, Annapragada AV. et al. Bone age determination using only the index finger: a novel approach using a convolutional neural network compared with human radiologists. Pediatr Radiol 2020; 50 (04) 516-523
    CrossrefPubMedGoogle Scholar
  • 17 Acheson RM, Vicinus JH, Fowler GB. Studies in the reliability of assessing skeletal maturity from x-rays. 3. Greulich-Pyle Atlas and Tanner-Whitehouse method contrasted. Hum Biol 1966; 38 (03) 204-218
    PubMedGoogle Scholar
  • 18 Gilli G. The assessment of skeletal maturation. Horm Res 1996; 45 (Suppl. 02) 49-52
    CrossrefPubMedGoogle Scholar
  • 19 Sanders JO, Khoury JG, Kishan S. et al. Predicting scoliosis progression from skeletal maturity: a simplified classification during adolescence. J Bone Joint Surg Am 2008; 90 (03) 540-553
    CrossrefPubMedGoogle Scholar
  • 20 Risser JC. The Iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop 1958; 11 (11) 111-119
    PubMedGoogle Scholar
  • 21 Li DT, Cui JJ, DeVries S. et al. Humeral head ossification predicts peak height velocity timing and percentage of growth remaining in children. J Pediatr Orthop 2018; 38 (09) e546-e550
    CrossrefPubMedGoogle Scholar
  • 22 Aucourt J, Budzik JF, Manouvrier-Hanu S, Mézel A, Cotten A, Boutry N. Congenital malformations of the hand and forearm in children: what radiologists should know. Semin Musculoskelet Radiol 2012; 16 (02) 146-158
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Goldfarb CA. Congenital hand differences. J Hand Surg Am 2009; 34 (07) 1351-1356
    CrossrefPubMedGoogle Scholar
  • 24 Ecklund K. Magnetic resonance imaging of pediatric musculoskeletal trauma. Top Magn Reson Imaging 2002; 13 (04) 203-217
    CrossrefPubMedGoogle Scholar
  • 25 Crum RP, Cervantes L, Berger AJ. Pediatric hand ultrasound: common indications, injury, inflammation and masses. Pediatr Radiol 2022; 52 (09) 1671-1686
    CrossrefPubMedGoogle Scholar
  • 26 Weintraub MD, Hansford BG, Stilwill SE. et al. Avulsion injuries of the hand and wrist. Radiographics 2020; 40 (01) 163-180
    CrossrefPubMedGoogle Scholar
  • 27 Lin JS, Samora JB. Outcomes of splinting in pediatric mallet finger. J Hand Surg Am 2018; 43 (11) 1041.e1-1041.e9
    CrossrefPubMedGoogle Scholar
  • 28 Elfar J, Mann T. Fracture-dislocations of the proximal interphalangeal joint. J Am Acad Orthop Surg 2013; 21 (02) 88-98
    CrossrefPubMedGoogle Scholar
  • 29 Abzug JM, Kozin SH. Seymour fractures. J Hand Surg Am 2013; 38 (11) 2267-2270 ; quiz 2270
    CrossrefPubMedGoogle Scholar
  • 30 Styron JF. Pediatric hand infections. Hand Clin 2020; 36 (03) 381-386
    CrossrefPubMedGoogle Scholar
  • 31 Reyes BA, Ho CA. The high risk of infection with delayed treatment of open Seymour fractures: Salter-Harris I/II or juxta-epiphyseal fractures of the distal phalanx with associated nailbed laceration. J Pediatr Orthop 2017; 37 (04) 247-253
    CrossrefPubMedGoogle Scholar
  • 32 Fleege MA, Jebson PJ, Renfrew DL, Steyers Jr CM, el-Khoury GY. Pisiform fractures. Skeletal Radiol 1991; 20 (03) 169-172
    CrossrefPubMedGoogle Scholar
  • 33 Doman AN, Marcus NW. Congenital bipartite scaphoid. J Hand Surg Am 1990; 15 (06) 869-873
    CrossrefPubMedGoogle Scholar
  • 34 Avenarius DFM, Ording Müller LS, Rosendahl K. Erosion or normal variant? 4-year MRI follow-up of the wrists in healthy children. Pediatr Radiol 2016; 46 (03) 322-330
    CrossrefPubMedGoogle Scholar
  • 35 Boavida P, Hargunani R, Owens CM, Rosendahl K. Magnetic resonance imaging and radiographic assessment of carpal depressions in children with juvenile idiopathic arthritis: normal variants or erosions?. J Rheumatol 2012; 39 (03) 645-650
    CrossrefPubMedGoogle Scholar
  • 36 Ording Muller LS, Boavida P, Avenarius D. et al. MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study. Pediatr Radiol 2013; 43 (07) 785-795
    CrossrefPubMedGoogle Scholar