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At least 235 records · Page 13Linked to original sources

Measurement error in grip and pinch force measurements in patients with hand injuries.

BACKGROUND AND PURPOSE: There is limited documentation of measurement error of grip and pinch force evaluation methods. The purposes of this study were (1) to determine indexes of measurement error for intraexaminer and interexaminer measurements of grip and pinch force in patients with hand injuries and (2) to investigate whether the measurement error differs between measurements of the injured and noninjured hands and between experienced and inexperienced examiners. SUBJECTS: The subjects were a consecutive sample of 33 patients with hand injuries who were seen in the Department of Rehabilitation Medicine of Erasmus MC-University Medical Center Rotterdam in the Netherlands. METHODS: Repeated measurements were taken of grip and pinch force, with a short break of 2 to 3 minutes between sessions. For the grip force in 2 handle positions (distance between handles of 4.6 and 7.2 cm, respectively), tip pinch (with the index finger on top and the thumb below, with the other fingers flexed) and key pinch force (with the thumb on top and the radial side of the index finger below) data were obtained on both hands of the subjects by an experienced examiner and an inexperienced examiner. Intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and associated smallest detectable differences (SDDs) were calculated and compared with data from previous studies. RESULTS: The reliability of the measurements was expressed by ICCs between .82 and .97. For grip force measurements (in the second handle position) by the experienced examiner, an SDD of 61 N was found. For tip pinch and key pinch, these values were 12 N and 11 N, respectively. For measurements by the inexperienced examiner, SDDs of 56 N for grip force and 13 N and 18 N for tip pinch and key pinch were found. DISCUSSION AND CONCLUSION: Based on the SEMs and SDDs, in individual patients only relatively large differences in grip and pinch force measurements can be adequately detected between consecutive measurements. Measurement error did not differ between injured and noninjured hands or between experienced and inexperienced examiners. Criteria for judging whether the measurement error does allow application of the measurements in individual patients are discussed.

Adolescent↗

[Hand injuries due to agricultural accidents (author's transl)].

Agricultural injuries are common in childhood. About a quarter of the cases shows injuries of the hand. These are sometimes very extensive and, particularly in younger children, open fractures or amputation of one or more fingers are often found. Machines for peeling maize-cobs, cutting and mixing fodder, and tractors are those implements which cause the commonest serious injuries to the hand. The high percentage of children under eight years of age among our cases clearly indicates the small account of safety measures held among country people. For successful accident-prevention it is therefore necessary to increase the consciousness of danger to children among the farming population by means of detailed information, as well as to carry out improvements on the machines themselves.

Adolescent↗

Mutilating hand injuries: principles and management.

The objectives of the treatment of mutilating hand injuries are to insure patient's survival, limb survival and ultimately limb function. Initially, patients are stabilized and cleared of other potentially life threatening trauma. The cornerstone to the early intra-operative management of the mangled hand includes irrigation and debribement. Skeletal stabilization, revascularization, replantation or the use of spare parts to restore functions are addressed at the initial surgery. Subsequent second or third look surgeries may be required to procure a clean wound bed. Regional flaps and free tissue transfer provides definitive coverage than soft tissue is required. Secondary procedures such as tenolysis, joint mobilization or toe transfers may be needed to restore dexterity to the healed yet dysfunctional hand. Adherence to sound safe principles help prevent further mobidity while fostering the restoration of hand function to return the patient to gainful activities.

Adult↗

Hand injuries at leisure.

In a survey of 383 moderate and severe hand injuries in adults, 246 (64.4%) occurred outwith work. Falling (sixty-four patients) and punching (forty-eight patients) were the commonest mechanisms of blunt injury. Glass (eight), knives (seven) and "do-it-yourself" materials (eight) were most frequently implicated in sharp trauma. No outstandingly dangerous hobbies or social activities were identified.

Adolescent↗

Epidemiology of hand injuries in a middle-sized city in southern Sweden: a retrospective comparison of 1989 and 1997.

Case notes of patients with hand injuries that required referral to our department in 1989 and 1997, were analysed retrospectively. The incidence of such an injury was at least 7/1000 inhabitants/year (12% of the patients seen in the orthopaedic Accident and Emergency department). Most of the patients were young men with minor injuries, most commonly injured during leisure activities. Only 22% of the patients who worked were injured at work, but such injuries increased the risk of admission to hospital. The amount of sick leave was significantly shorter in 1997, and 77% of the workers were off work for less than two months. There was a reduced risk of injury during July, November, and December, and on Tuesdays. Type and range (type/mechanism/severity) of injuries differed slightly between the years and among the various age groups. Epidemiological data about hand injuries that affect young patients of productive age, are important to optimise resources and organisation of the health care system.

Accidents, Occupational↗

The free fibular flap: a useful flap for reconstruction following composite hand injuries.

The free fibular flap has been used extensively in facial and extremity long bone reconstruction but has not been presented as a tool for reconstruction following composite hand injuries, in particular for reconstruction of the ulnar border of the hand. We present a case of the use of this flap for reconstruction of such a complex composite hand injury.

Accidents, Traffic↗

Hand injuries in cricketers.

55 patients with 64 injuries of the hand sustained while playing cricket were reviewed, 46 clinically. Most of the injuries were during fielding. The peripheral digits were most frequently involved and joint injuries predominated. Though the majority of the patients had a satisfactory functional outcome, some admitted to occasional pain and persistence of swelling and/or minor deformity. The most serious injuries were eleven fractures of the base of the middle phalanx with dislocation of the P.I.P. joint.

Adolescent↗

[Primary treatment of mutilating hand injuries (author's transl)].

The management of badly multiplating hand injuries is reported on the basis of 130 cases treated as in-patients. It is divided into estimation of the injuries, operative procedure and post-op. care. The operation itself comprises 4 stages: - intensive exploration - debridement - reconstruction of underlying structures and - treatment of the skin It is essential to conserve all those structures of the hand which are still living. If at all possible, the first operation should also be the main one. In any case, everything should be done to facilitate the secondary procedure. The final result should guarantee the functions of grasp and touch.

Adolescent↗

Hand injuries from snow blowers: a report of an epidemic.

During a record snowfall in Worcester, Massachusetts, 11-13 December 1992, 37 male patients with hand injuries suffered during snow blower operation were seen at three area hospitals. Two previous reports describe 13 patients seen over a 3-year period and 28 patients over a 12-year period. This report describes the largest number of hand injuries from snow blowers that have occurred over a 48-hour period. The snow was unusual because of the high water density in the initial 9 inches (23 cm) that fell at an average temperature of 33 degrees F (0.6 degree C) with the final depth of 30 inches (76 cm), causing the machines to become clogged. Patients admitted to reaching into a running machine in 35/37 (95%) cases, 11/37 (30%) claimed the auger and impeller blades were disengaged, and 2/37 (5%) patients claimed their injuries occurred with the engines turned off. All injuries occurred when the patients placed their hands down the chute, contacting the impeller blades. Injuries involved 32 long, 15 ring, 13 index, and five small fingers and ranged from simple lacerations to partial phalangeal amputations. The majority, 27/37 (73%), were managed in emergency departments without interventions in the operating suites. Infection occurred in one patient who had the lesion repaired in the operating suite. As in previous studies, no differences were found for the variables of snow-blower age, type, or horsepower, or on experience level or age of the operators.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Hand injuries].

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Hand↗

[Hand injuries].

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Hand↗

[Hand injuries due to fireworks explosion].

Two different series of patients with burst injuries of the hand were retrospectively reviewed: one series included 23 men, 15-55 years old, referred to the emergency department for the first-instance assessment of injuries of the right hand (13 patients) and left hand (10 patients). The other series included 44 patients (42 men and 2 women, aged 7-61 years) referred to our department for second-instance examinations: the latter patients had burst injuries involving only the hands in 43 cases and both the hand and the foot in one case. We report the radiologic patterns of traumatic bone injuries (fractures and amputations) and of musculotendinous and cutaneous injuries and discuss their mechanisms and pathogenesis. The two series were compared and the results follow: in both series the right hand was more frequently involved, metacarpal bones were most often fractured and phalanges most often amputated. In the first series, in the right hand the carpal bones were involved in one patient only, the 2nd and 3rd metacarpal bones were most frequently fractured and the 2nd finger was most frequently involved. In the left hand, the carpal bones were never affected, the 1st metacarpal bone was most often amputated and the 5th metacarpal bone most often fractured; the 2nd finger was most frequently involved. In the second series, in the right hand, the 1st metacarpal bone was most frequently fractured and the 2nd metacarpal bone most often amputated; the 2nd finger was most frequently involved. In the left hand, the 4th metacarpal bone was most frequently fractured and the 5th metacarpal bone most often amputated. The severity of the above injuries and the extent of tissue damage depend on several factors, including firecracker speed, shape, size, weight and characteristics. Radiologic exams are very useful for the accurate study of these traumatic injuries, providing indirect information about musculotendinous and cutaneous involvement. Prompted by the relative lack of information on the management of these injuries, we suggest that radiologic exams be quickly performed to help choose the most appropriate surgical approach for best cosmetic and functional results.

Adolescent↗

Medico-economic implications of industrial hand injuries in India.

625 five consecutive cases of industrial hand injuries attending the Employee's State Insurance Hospital, Jaipur, have been studied from 1983 to October 1986. The incidence of injuries was 36 per 10,000 workers per year. 47% were due to entrapment of the hand in active machines, 25% occurred during lifting and transportation of heavy objects and 12% while handling tools. The injuries resulted in residual deficit in 55% of cases and were serious enough to require absence from work of more than four weeks in 48% of cases. On an average 35 days were lost per injured worker. The average economic loss per injured worker was Rs. 6900 (approximately pounds 275) for workers in the wage-range of Rs. 5400 to 19,200 (pounds 216 to pounds 768) per annum.

Accidents, Occupational↗