The use of corporal punishment in educational settings has become increasingly rare. The U.S. is the only advanced industrial nation that fails to prohibit the practice. In 21 states, persons in charge of pupils may legally batter them as a form of punishment. Opposition to reform is centered mainly in the rural south.

One such method of corporal punishment is to strike children on the hand using a variety of implements such as a wood or metal ruler or a leather strap. In this statement, the undersigned address the potential physical risks incurred by children when their hands are struck in this manner.

There exists a whole range of orthopedic complications which can result from striking the hand of a child with a cane, ruler, strap or other such implement. The hand is particularly sensitive to injury because of the proximity of the ligaments, tendons, nerves and blood vessels to the skin, which does not have underlying protective tissue. Younger children are even more susceptible to permanent deformity because of the possibility of injury to growth plates in the bones. Injuries can range from fractures to dislocation, particularly to the terminal phalangeal joint, which could possibly lead to premature osteoarthritic changes. There are also risks of developing severe infections in the fascial spaces of the hand, particularly if there are pre-existing undiagnosed subungual infections. Infections of the hand often require hospitalization, and create a significant risk of loss of function of the hand.

• Zeno Chicarilli, M.D., American Society for Surgery of Hands; American Society of Plastic and Reconstructive Surgeons; Clinical Assistant Professor of Surgery, Yale University, Connecticut
• Bernard J. Cullen, M.D., Fellow of the American Academy of Pediatrics; Associate Professor of Pediatrics and Director of the Child Abuse Prevention Program at the Medical College of Ohio.
• Norman M. Harris, M.D., Fellow of the American College of Surgeons (FACS); Fellow of the American Academy of Orthopedic Surgeons (AAOS), Piedmont, California
• Alexander Kalenak, M.D., Professor of Orthopedic Surgery; Director of the Sports Medicine Program at the College of Medicine, Pennsylvania State University, Hershey, Pennsylvania
• James R. Lewis, M.D., Fellow of the American College of Surgeons (FACS); Fellow of the American Academy of Orthopedic Surgeons (AAOS); San Juan, Puerto Rico
• Richard E. McCarthy, M.D., Fellow of the American College of Surgeons (FACS); Fellow of the American Academy of the Orthopedic Surgeons (AAOS); Clinical Associate Professor of Orthopedics and Pediatrics at the University of Arkansas for Medical Sciences, Arkansas Children's Hospital
• Barry McKinley, M.D., Orthopedic surgeon, Berkeley Orthopedic Medical Group, Berkeley, California
• R. K. Oates, M.B., B.S., Professor of Pediatrics and Child Health, University of Sydney, Chairman of the Division of Medicine at the Royal Alexandra Hospital for Children, Camperdown, New South Wales, Australia
• Robert Poss, M.D., Associate Professor of Orthopedic Surgery, Harvard Medical School; orthopedic surgeon, Brigham and Women's Hospital, Boston, Massachusetts
• Edwards P. Schwentker, M.D., Associate Professor of Surgery, Division of Orthopedic Surgery, Pennsylvania State University; Medical Director of the Elizabethtown Hospital and Rehabilitation Center, Pennsylvania
• Anthony Shaw, M.D., Professor of Surgery, University of California, Los Angeles, Chief of Pediatric Surgery, Olive View Medical Center, Sylmar, California
• Lesli Ann Taylor, M.D., Pediatric Surgery, Children's Hospital of Philadelphia, Pennsylvania