ABSTRACT
Pediatric hand trauma remains somewhat of a black box even to the most experienced traumatologist. Neurological evaluation of the pediatric hand varies depending upon the age, willingness to cooperate, and state of consciousness of the child. Ideally, both motor and sensory exams can be thoroughly completed. Full consideration must include three major nerves that innervate the hand, namely, the median, ulnar, and radial nerves. Very few diagnostic modalities add significantly to the astute clinical exam in the acute situation. However, in accordance with the American College of Radiology (ACR) Appropriateness Criteria, plain three-view radiographs (posteroanterior (PA), lateral, and oblique) that include the joints immediately proximal and distal to the area of trauma can be helpful and are usually indicated. Extensor injuries are more common given their superficial location in the hand. Suspected injuries should be explored and repaired under tourniquet control in the operating room.
