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At least 271 records · Page 15Linked to original sources
PubMed2006

Work-related hand injuries: case analyses in a Brazilian rehabilitation service.

PURPOSE: Professionals who work with rehabilitation of the hand usually assess performance components as their main outcome measures. Intervention is aimed at normalization of deficits of these components, with the expectation that the integrity of the structures and functions of the body will revert to improvements in the client's functional performance. The objectives of this study were to describe changes in patients who received rehabilitation in a Brazilian public hospital after having suffered hand injuries due to workplace accidents, and to examine the relations between performance components and levels of functioning. METHODS: Observational cross-sectional study was used. A convenience sample was selected, including 42 patients assessed at service admission and at discharge. Assessed characteristics included grip strength, wrist and finger range of movement (ROM), sensitivity, and self-perceptions of functional performance (COPM). Statistical procedures included correlations between performance components and COPM scores and differences on selected variables at admission and discharge. RESULTS: Significant improvements in all assessed functional components. COPM values increased more than 100% after intervention (effect size d = 1.996 for performance and d = 1.553 for satisfaction) demonstrating improvements in both domains. Low correlations between grip strength and COPM scores were found only at admission (r = 0.314; p = 0.045). When the relationship between gains in strength and COPM scores at discharge were examined, significant correlations were found with the performance (r = 0.324; p = 0.039) and satisfaction (r = 0.0326; p = 0.038) subscales. CONCLUSIONS: Results of this study provide evidence for functional gains in clients treated in a rehabilitation service and supply information about the relation between specific components and functional performance.

Activities of Daily Living↗
PubMed2000

[Treatment strategy in complex hand injuries].

There are no clear definitions of serious or complex hand injuries in the literature. Multistructural injuries involving a vital risk to the affected part of the body part are usually classified as complex. The quality of the reconstruction, based on sound management principles, determines the aesthetic and functional outcome for the patient. The strategies basically consist of: Careful radical dbridement, thorough analysis of the defect and evaluation of lost functions, injury classification, Patient oriented reconstructive procedures, careful and realistic explanation of perspectives and risks to the patient. Following these principles will most likely achieve the planned objectives of treatment, such as, best possible restoration of form and function, cost-effective therapy, and early professional and social reintegration. Algorithmic approaches are an important aid in the clinical approach to these kinds of problems, making it possible to reach clear reproducible decisions that are amenable to standardization. Despite all individual decisions necessary to achieve optimal care, this standard theoretical framework will be able to improve the quality of care.

Algorithms↗
PubMed1983

Common hand injuries in the athlete.

Common injuries to the hand and wrist of athletes have been discussed under the headings of ligament injuries, fractures, tendon injuries, and neurovascular injuries. Although the frequency and mechanisms of certain injuries may be different in the athlete than in the nonathlete, the principles of proper early diagnosis and adequate treatment are the same whether the patient is an athlete or not.

Athletic Injuries↗
PubMed1980

Common hand injuries in the athlete.

Common injuries to the hand and wrist of athletes have been discussed under the headings of ligament injuries, fractures, tendon injuries, and neurovascular injuries. Although the frequency and mechanisms of certain injuries may be different in the athlete than in the nonathlete, the principles of proper early diagnosis and adequate treatment are the same whether the patient is an athlete or not.

Athletic Injuries↗
PubMed1986

Rehabilitation of hand injuries in athletes.

This article outlines and stresses the importance of proper rehabilitation of hand injuries in athletes. Rationale for guidelines in splinting, modalities, and appropriate progression of various types of exercise is discussed.

Athletic Injuries↗
PubMed2004

[Hand injuries in elderly patients].

We studied 1199 patients treated in II Department of Surgery in Cracow between 1987 and 2000. In the studied group, 138 patients were aged over 60 years. In most cases the injury took place at home (43.68%) and more often than not they occurred during operating mechanical equipment (52.89%) among which circular saw predominated (35.51%). It was revealed that the hand injuries of senior patients were more severe compared with the other patients and the permanent post-injury disability was more intense. The elderly patients with multi-tissue hand injuries should be treated in specialist centers. It is also essential to start as soon as possible the therapeutic rehabilitation (even during surgical treatment). Only such proceedings enable better final results of treatment.

Age Distribution↗
PubMed1992

Evaluating acute hand injuries in the emergency department: a comparison of physicians with varying postgraduate training backgrounds. St Louis Emergency Physicians' Association Research Group.

This study compared the quality of the history, physical examination, and treatment of patients with hand injuries performed by emergency physicians with varied training backgrounds. Four hundred ninety-seven patients with isolated hand injuries were evaluated by 97 physicians, who were classified into four groups: (1) emergency medicine board certified, (2) primary care specialty board certified, (3) non-board certified, and (4) moonlighting residents. The history and physical examination were separated into several variables to define deficiencies. Adequacy of treatment were determined by two emergency physicians and an orthopedic surgeon. Significant differences were found in five categories. Group no. 4 documented the history and followed the Centers for Disease Control tetanus prophylaxis guidelines better than did groups no. 1 or 2. Group no. 1 obtained x-rays less often than any other group and had a better treatment score, but the latter did not reach statistical significance. Physicians of lesser training are more meticulous about documenting a history and following treatment protocols than are residency-trained or boarded emergency physicians, but order more tests and are less likely to document adequate treatment.

Acute Disease↗
PubMed2004

Immediate toe-to-hand transfer in acute hand injuries: overall results, compared with results for elective cases.

In the past 5 years, 25 mutilated digits were reconstructed with immediate toe-to-hand transfers after acute hand injuries, for 21 patients. The overall results of the immediate toe-to-hand transfers were evaluated and compared with the results of 65 elective procedures performed during the same period by the same surgeon. There were 15 cases of great toe-to-hand transfer for thumb reconstruction, two cases of second toe transfer for index finger reconstruction, and four cases of simultaneous two-toe transfer for reconstruction of multiple-digit amputations. Two cases (two of 25 cases, 8 percent) were successfully salvaged with emergency reexploration. The incidences of emergency reexploration and postoperative infection were not significantly different from those for elective toe-to-hand transfer cases. The duration of industrial insurance coverage was much shorter than for elective cases, averaging 225 days (p < 0.001). Approximately 44 percent of the patients maintained their original jobs after immediate toe-to-hand transfer. The subjective satisfaction self-assessment scores of aesthetic appearance and function for the newly reconstructed thumb averaged 80 and 88 (of a total score of 100), respectively. Although satisfaction was lower than for elective reconstruction (p < 0.001), it was higher than for reconstruction of other digits. The donor-site appearance after great toe harvesting was mostly unsatisfactory. Immediate toe-to-hand transfer provides many advantages over the elective procedure in acute hand injuries, including single-stage reconstruction, shortened convalescence, early return to work, and socioeconomic efficiency. Because there were no significant differences in the success rates, frequencies of complications, or ultimate functional results, immediate toe-to-hand transfer is a safe and reliable procedure that is indicated for specific cases of acute digital amputation.

Acute Disease↗
PubMed2000

[Hand injuries caused by self-made bombs. Observations and reconstructoin techniques. Report of 7 cases].

The authors report on their experience of sodium chlorate bomb injuries of the hand observed in seven boys. The thumb was damaged in all cases. This digit was amputated in five cases, was totally saved in one case and partially saved in another case. In four cases, the preservation of damaged tissues in the emergency procedure allowed a secondary reconstruction of the thumb, thus making it possible to achieve a prehensile and sensitive hand. In these former four cases, a posterior interosseous flap was performed to ensure the primary or secondary skin coverage. In two cases, the major lesions necessitated an amputation at the radiocarpal level. In one of these two cases, coverage of the amputated stump by a free gracilis muscle flap made it possible to minimize the level of amputation and to wear a functional prosthesis. Sodium chlorate bombs are made with an unstable chemical mixture. These reactives provoke high-energy injuries with a short range of dispersion. The damages depend on the prehensile mode, which explains why the thumb and the index finger are always injured. These blast injuries were limited to the hand and the skin coverage could be done with a distally based posterior interosseous flap. In spite of the impressive lesions observed in such young patients, a conservative attitude could be taken in an emergency situation with the aim to perform further reconstructive procedures.

Adolescent↗
PubMed1992

An audit of hand injuries in a paediatric accident and emergency department.

This paper documents hand injuries in the paediatric population presenting to a Paediatric Accident and Emergency Department over a two month period. Unlike other childhood accidents, they showed no marked male preponderance, nor age pattern. While most injuries were relatively minor and were able to be managed in the Accident and Emergency Department, a small minority were referred for specialist treatment.

Adolescent↗
PubMed2003

Psychological aspects of mutilating hand injuries.

The immediate and long-term outcome of a mutilating hand injury can be positively influenced by health care professionals adopting a biopsychosocial perspective toward treatment and management. Such an injury produces a psychological and social impact that should be openly and candidly addressed with the injured individual and with the family. The earlier and the more skillfully these issues are addressed, the more likely it is that psychological factors will not impede functional outcome.

Accidents, Occupational↗
PubMed1985

Hand injuries--special considerations in children.

Injuries to the hand are very common in children. Because of children's tremendous capability of repair, fingertip injuries can usually be treated with dressings, and complicated closures with flaps or grafts can be avoided. Fractures are common, and the treating physician must be aware of the various ephiphyseal injuries that can occur in the hand. Because children are so active, if the hand must be immobilized, a long arm cast or valpeau dressing will usually be required.

Child↗
PubMedDate not supplied

[Accident prevention and emergency treatment of traumatic hand injuries in the metropolitan area of São Paulo].

The workman's hand is a "tool"; it is his most valuable asset. Worker selection and training, associated with a preventional approach, by employee and employer, humanises work and makes it more effective. The rate of hand injuries in the city of São Paulo is very high (of the order of 500 cases per day) and its aggregate cost is extremely high. The primary care of lesions is so poor that it well deserves the label of "second accident". The CIPAM-SUDS/SP system will provide a simpler and proper treatment by trained surgeons in full time duty in first-aid decentralized stations, located inside the industrial areas.

Accidents, Occupational↗
PubMed1992

[Diagnosis and management of hand injuries caused by foreign bodies].

The authors survey the possibilities of diagnosis of the frequent injuries of the hand caused by foreign bodies. It is proven by them that almost all foreign bodies can be demonstrated using radiological methods (native picture, ultrasound examination, xeroradiography, CT, MRI). They support the immediate surgical care in the therapy of injuries caused by foreign body, they deal however with the problems of the later therapy, too. Their opinion is backed up by the demonstration of case reports.

Accidents, Home↗
PubMed1987

Radiology of wrist and hand injuries in athletes.

Traumatic injuries are a major cause of hand and wrist pain in athletes. Wrist injuries include fractures, dislocations, and instability patterns. Hand injuries include tendon injuries, ligamentous injuries, and fractures. In this article we have presented the radiographic appearance of the more common of these injuries.

Athletic Injuries↗