Although the exact number of children that sustain hand and wrist injuries is unknown, there have been many studies conducted in the United States and abroad during the past 10 years that provide valuable information regarding common mechanisms of injury, frequently sustained injury patterns, and injury patterns suspicious for abuse that may be of benefit in the care and treatment of the general pediatric population. The authors of this article provide a comprehensive review of pediatric hand and wrist injuries with a special emphasis on the unique aspects of management.
Child abuse is not uncommon and frequently presents to the emergency department (ED). Sometimes the presentation is subtle and masked by vague histories and nonspecific physical findings. Considering sexual abuse in the differential diagnosis is important for the child and his or her safety. Understanding techniques for obtaining a directed history and recognizing the physical findings and abnormalities that are associated with abuse will enable the physician to complete a thorough evaluation and to document with confidence. High-risk populations, such as children with special needs, present unique challenges to the clinician. This article reviews the history, physical examination, diagnostic evaluation, and reporting expectations for children with suspected sexual abuse.
