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PubMed1978

[Treatment of hand injuries on the principle of "delayed emergency"].

A certain number of drunk patients who suffered hand injury were not prone to operation on the day of admission, as usual, for different reasons (behaviour of the patient etc.). These patients were treated on the delayed urgency principle, that Iselin worked out. Results in the 266 cases were surprisingly good. There were much less complications with this method, compared to previous results achieved when primary treatment of wounds was practised. Yet more experience is necessary, to work out certain details and more exact indications, the authors state.

Accidents, Occupational↗
PubMed1993

Psychologic assessment of patients with industrial hand injuries.

The benefits and rationale for including a psychologic assessment of a patient with an industrial hand injury are discussed. Issues of compliance and malingering in patients are addressed. The role of pre-existing conditions in understanding an injured patient's current emotional state is explored and contrasted with posttraumatic stress disorders. Recent trends in psychologic assessment techniques are highlighted.

Accidents, Occupational↗
PubMed1985

Hand injuries in south Wales coal miners.

Fifty eight coal miners attended the Royal Gwent Accident and Emergency Department with serious hand injuries over a three year period. The commonest cause of the injuries was falling rock or coal from the pit roof crushing the hand and the commonest type of injury was the crushed, compound fracture of the terminal phalangeal area of the digit, with or without pulp loss. Records of the time off work with the injury were obtained in 52 miners. Only seven (13%) returned to work within one month. Of 40 individual distal phalangeal injuries reviewed after one year, only four (10%) had normal sensation and full movement at the distal joint. Nevertheless, only seven miners (13%) had to alter their initial occupation at the mine and move to lighter duties.

Accidents, Occupational↗
PubMed1988

Self-inflicted hand injuries: diagnostic challenge and treatment.

Self-inflicted injuries are probably more common than is generally appreciated. Three patients with self-inflicted hand injuries are described. A delay in making the correct diagnosis resulted in severe hand disability in 2 of the patients. Early diagnosis of this entity, combined with prompt psychotherapy, prevented disability in the third. The pertinent literature is reviewed and the importance of early diagnosis and psychotherapy is stressed.

Adolescent↗
PubMedDate not supplied

Hand injury patterns in softball players using a 16 inch ball.

Softball is a popular recreational and competitive sport among both men and women. The injury rate in softball players is as high as that in baseball and basketball players. We conducted a retrospective analysis of 119 hand injuries in 108 patients treated at the University of Chicago hand clinic. All of the injuries were caused by the impact of a 16 inch circumference softball. Of the 119 injuries, 87 (73%) had bone involvement. Operative treatment was required in 26 (22%) injuries, 23 involving fractures and 3 involving soft tissue only. There was one (3.8%) operative complication. Of all injuries, 101 (86%) involved the finger joints, including 46 (39%) injuries to the distal interphalangeal (DIP) joint, 48 (40%) to the proximal interphalangeal (PIP) joint, and 7 (6%) to the metacarpophalangeal (MCP) joint. The most common DIP joint injury was a mallet injury. This fracture, the most common single type of injury in our series, accounted for 27% of all injuries. Of all mallet injuries, 86% were fractures. The most common PIP joint injury was a volar plate fracture, the second most common injury in our series. Variables such as the patient's sex, dominance or nondominance of hands, and early or late season play were not associated with a higher risk of injury. Certain parts of the hand, such as the more ulnar digits and the DIP and PIP joints, were at particularly high risk of injury.

Adolescent↗
PubMed2006

Recommendations for the improvement of hand injury care across the world.

This paper discusses the four aspects, which need attention if the management of hand injury is to improve globally. These areas include the provision of information, targeted education, relevant and well-supported audit and research and the improvement of infrastructure. The paper explores what needs to be done, the time frame for improvement and how this may be achieved. The strategy developed needs to remain sensitive to the local needs and capacity.

Delivery of Health Care↗
PubMed1988

Early psychological aspects of severe hand injury.

We investigated the incidence and nature of psychological symptoms occurring during the first two months after severe hand injuries. 94% of patients had significant symptoms at some point early in rehabilitation, including nightmares (92%), flashbacks (88%), affective lability (84%), preoccupation with phantom limb sensations (13%), concentration/attention problems (12%), cosmetic concerns (10%), fear of death (5%), and denial of amputation (3%). Two months later, flashbacks (63%) remained pronounced. Nightmares (13%), affective lability (48%), concentration/attention problems (5%), fear of death (0%), and denial of amputation (0%) declined markedly, while cosmetic concerns (17%) and preoccupation with phantom limb sensations (17%) increased. Based on these findings, we believe that psychological treatment should often be given as part of the rehabilitation process.

Affective Symptoms↗
PubMed1998

[Hand injuries in the users of hydraulic wood-cutters].

This study has been carried out in order to suggest possible prophylactic recommendations. We investigated the type of injuries, the type of logsplitter used, the injury circumstances and the safety measures. Fifty-two patients were included. There were a total of 21 crushing injuries with amputations of fingers, hand, on forearm. Nine replantations, two revascularisations and seven amputations were carried out. Eighty-eight percent of the patients had their hand in the splitting area. Sixty-seven percent had not received any instructions on how to operate the machinery. In 58% of the cases two or more persons were operating the logsplitter and 40% of the machines had no emergency stop button. The hazards mentioned above influenced the injury frequence and severity. We therefore recommend improved prophylactic measures and precautions to be considered. For the old machines a campaign will be necessary, and for new logsplitters we recommend implementation of new standards.

Accidents, Home↗