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[Therapy of soft tissue trauma in the acute phase of severe hand injuries].
INTRODUCTION: Complex hand injuries are characterized by a combination of soft tissue injury and additional trauma to functional structures such as nerves, bones, tendons, vessels and joints. A good functional result requires the reconstruction of the injured structures and early mobilisation. Good vascularized soft tissue and stable osteosyntheses are the major prerequisites to avoid infections and to allow early mobilisation. The optimal timing for soft tissue reconstruction remains controversial with respect to the incidence of infections. METHODS: We have evaluated retrospectively our series of complex hand injuries addressing the question whether a delay of soft tissue coverage for up to 72 hours causes significant increase of infection rates. RESULTS: 48 patients were treated with complex injuries of the hand within a three year period between December 1998 and December 2000. The lowest incidence of infections occurred in the group, where soft tissue coverage was completed as an emergency procedure. DISCUSSION: Ideally primary reconstruction of complex hand injuries should be strived for to minimize scar formation as a result of secondary operations and further immobilisation periods. This includes, if necessary, free tissue transfer. Exceptions are situations where the vitality of soft remains uncertain. In these cases, definitive surgery is delayed for a maximum period of 72 hours.
The management of hand injuries.
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Occupational hand injuries.
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Symposium on treatment of hand injuries.
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Common fractures of the hand--injuries of the hand.
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Mechanical cornpicker hand injuries.
Mechanical cornpicker hand injuries are not frequent in comparison to general hand trauma, but they have a specific mechanism of occurrence and are very severe. This investigation included 221 hand injuries. The sex distribution shows a general male dominance (85.25%) in their active age (84.44%). These are, seasonal injuries mostly occurring in October (75.11%). By type of injuries, mutilating crush injuries are most frequent (64.25%). After completing the treatment, in most cases the functional result were estimated as bad (50.68%). Data concerning education and trainig for operating agricultural machines (96.38%--patients without training) and carrying out safety measures (63.35% of injured patients did not apply any protection measures) are devastating. The number of these injuries, as well as consequent permanent disabilities, may be considerably reduced by preventive measures, inclulding public health services and media. Use of contempoarary agricultural machinery, as well as obligatory training for operating these machines and application of protective measures, may also reduce the incidence of hand injuries during corn picking.
[Surgical therapy of frequent hand injuries. 1: Fractures and capsular ligament injuries].
The hand is often involved in accidents and injuries. Most of these injuries can be treated adequately by the physician providing initial care. This paper gives the reader an outline of the most common hand injuries with the aim of facilitating recognition of the involvement of functional structures and thus ensure proper treatment or referral to the specialist. If a good functional results is to be achieved, misalignments in the longitudinal and transverse axes or torsional misalignments must be avoided. Fixation procedures facilitate provision of early-functional aftercare. In the event of injuries to the capsular ligament, a differentiation between complete and incomplete ruptures is of decisive importance for the further treatment.
The treatment of hand injuries.
A major hand injury can completely change a person's life. The consequences of the injury can be reduced by proper assessment, appropriate treatment and careful follow-up. Whenever experienced help is available then it should always be sought. This article describes the management of hand injuries. In Papua New Guinea the worst disasters occur when injuries are missed on initial assessment and the patient is not referred to a surgeon. Another common cause of poor outcome is failure to splint the hand in the correct position.
[Hand injuries with particular reference to industrial accident based on 4,000 cases treated at the Clinic for Hand Injuries and Diseases in Lódź].
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