Wound Treatment in School-Age Children " Jaxon is a 13-year-old male who has had swelling to his right hand "

Case study ( 2377 views as of December 17, 2018 )

Jaxon is a 13-year-old male who has had swelling to his right hand at the second and third knuckles over the last three days. He has small cuts over each, and yellow drainage from one of the wounds. He cannot fully close his fist due to the pain and swelling. His mother noticed just that morning when Jaxon had trouble closing his backpack before school, and when she questioned him, Jaxon reports that he tripped at school and 'fell on his fist'.

Jaxon should be seen by his primary care provider, and/or the emergency department. It is unusual to fall on a closed fit, so his mother and the adults caring for him should wonder about the truth of how Jaxon's injury was sustained. Injuries over the knuckles should always raise suspicion for a punch-related mechanism. Cuts over the knuckles due to contact with someone else's mouth are commonly referred to as a 'fight bite', and carry the same risks of secondary infection as a bite wound. Further, injury to the tendons and contamination of the joint or bones is a consideration. A fracture in the bones of the hands should be excluded as well.

Jaxon is also a minor, and if he has been in a fight, consideration of him being bullied, or being a bully, should be explored. Other injuries should be considered, as he may not be forthcoming about where he is hurt. Jaxon may benefit from excellent wound care, antibiotics, splinting/bracing and hand physiotherapy. He may also require some social and mental health support, including interventions at the school level.

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Conversation based on: Wound Treatment in School-Age Children " Jaxon is a 13-year-old male who has had swelling to his right hand "

Wound Treatment in School-Age Children " Jaxon is a 13-year-old male who has had swelling to his right hand "

  • Is there any type of vitamins / minerals a school age child should be taking to help with healing ?
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    • I have been giving my son Vitamin C each morning for the past 5 years or so. When he gets hurt he does not bruise too badly and heals quickly. I didn't know that this was something that would help with healing - thank you.
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    • Vitamin C is also good for keeping blood vessels strong and helping with bruising
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    • @ShirleyG, see my post below!
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  • I think the fact that he didn't mention it to his parents or at school lends weight to the possibility it was fight related. I would definitely be having a conversation with his teachers and possibly the principal
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  • Understanding the reason for Jaxon's injury is no doubt important, so his current and future mental health can be addressed. In terms of his physical wound healing, it will also be important for Jaxon to maintain a good intake level of Vitamin C. He's unlikely to be deficient if he's getting enough fruits and vegetables, but it's something to keep in mind given that Vitamin C is necessary to form the collagen that helps wounds heal.
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    • Vitamin C plays a particularly special role in that collagen formation needed for wound closure, but maintaining good status for all nutrients is important for the body's overall ability to function and respond to wounds etc. So, ensuring consumption of a diet adequate in all nutrients is no doubt important - this can be achieved by eating a variety of whole foods.
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    • Is it only vitamin C that can help aid in healing wounds ?
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  • Jaxon's wound definitely does seem suspicious, and while taking proper care of his injury to make sure it heals well is important, I think that his parents should try to keep him talking about what's going on at school. Perhaps getting the school guidance counsellor involved would be helpful if Jaxon isn't opening up at home.
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    • This injury does seem a bit suspect. Falling on a closed fist, while not impossible, is very hard to do. Seeking advice of a school counsellor or doctor would be a good thing to do.
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