Journal of Trauma and Injury

Original Article

Patients with intentional punch injuries in the emergency department: a retrospective cohort study: İbrahim Toker, Ömer Salt, Taner Şahin, Mükerrem Altuntaş, İrfan Gökçek, Murat Eşlik, İbrahim Tüysüz, Baycan Kuş, Muhammed İslam Özer; J Trauma Inj. 2025;38(1):32-37. Published online March 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0022

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Abstract PDF: Purpose
Hand and wrist injuries represent some of the most common traumatic conditions encountered in the emergency department (ED). Our study aimed to elucidate the demographic and clinical characteristics of patients sustaining intentional punch injuries.
Methods
This single-center retrospective study involved patients aged 16 years and older who presented to the ED with intentional punch injuries in 2023.
Results
A total of 405 patients were included in the study. The median patient age was 30 years (interquartile range, 22–40 years), and 363 (89.6%) were male. Among the patients, a total of 389 fractures were identified in 362 patients (89.4%). Metacarpal bone fractures were the most common, with 372 fractures (95.6%). The fifth metacarpal was the most frequently injured (67.4%), followed by the fourth (10.0%) and third (7.7%) metacarpals. Although the most common base fracture occurred in the first metacarpal, shaft fractures were most prevalent in the second, third, fourth, and fifth metacarpals. Overall, 259 patients (71.5%) had nondisplaced fractures. Additionally, 31 patients (7.7%) had previously been admitted to the ED for punching, 17 (4.2%) had prior ED visits for trauma resulting in a fracture, and 63 (15.6%) reported a history of psychiatric drug use.
Conclusions
Young men represent the majority of intentional punch injury patients. The fifth metacarpal and its shaft fractures were most commonly observed. A history of prior ED visits for punching or trauma, as well as psychiatric medication use, may serve as potential risk factors.; Summary

Review Article

Delayed union of a pediatric lunate fracture in the United Kingdom: a case report and a review of current concepts of non-scaphoid pediatric carpal fractures: Timothy P. Davis, Elizabeth Headon, Rebecca Morgan, Ashley I. Simpson; J Trauma Inj. 2023;36(4):315-321. Published online December 20, 2023; DOI: https://doi.org/10.20408/jti.2023.0038

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Abstract PDF: Pediatric carpal fractures are rare and often difficult to detect. This paper reviews the current literature on pediatric non-scaphoid carpal fractures, with a case report of a lunate fracture associated with a distal radius and ulnar styloid fracture, managed nonoperatively in a 12-year-old boy. There is lack of consensus regarding the management of these fractures due to the low number of reported cases. A frequent lack of long-term follow-up limits our understanding of the outcomes, but good outcomes have been reported for both nonoperative and operative management. This case report brings attention to the current time period for the definition of delayed union in pediatric carpal fractures, and emphasizes the need for prolonged follow-up for the detection of delayed complications leading to functional impairment.; Summary

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