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PubMed2005

Characteristics of pediatric traumatic amputations treated in hospital emergency departments: United States, 1990-2002.

OBJECTIVE: To examine the characteristics of children with traumatic amputations and the products associated with these injuries. METHODS: Data regarding amputation injuries to children younger than 18 years treated in US emergency departments from 1990 to 2002 were obtained from the National Electronic Injury Surveillance System. Data included demographics, product involved, and body region injured. RESULTS: An estimated 111,600 children younger than 18 years with amputation injuries were treated in US emergency departments from 1990 to 2002. The average age was 6.18 years (median: 4 years; mode: 1 year old). Males experienced 65.5% of these injuries. Finger amputations accounted for 91.6% of all amputations, ranging from 95.2% among 0- to 2-year-olds to 87.9% among 13- to 17-year-olds. Complete amputations accounted for 70.2% of all amputations among 13- to 17-year-olds compared with 52.6% of amputations among 0- to 2-year-olds. Adolescents also had the highest proportion of amputations resulting in hospital admission (26.6% for 13- to 17-year-olds compared with 11.9% for 0- to 2-year-olds). Adolescents had the highest proportion of amputation injuries involving lawn mowers (14.1% for 13- to 17-year-olds compared with 1.4% for 0- to 2-year-olds) and the highest proportion of amputations involving tools (29.3% for 13- to 17-year-olds compared with 2.5% for 0- to 2-year-olds). The percentage of amputations involving doors peaked in the youngest age group and decreased as age increased (65.8% of all amputations for 0- to 2-year-olds compared with 14.1% for 13- to 17-year-olds). CONCLUSIONS: To our knowledge, this is the first study to use a nationally representative sample to broadly investigate amputation injuries among children. The majority of traumatic amputation injuries occur to young children, to males, and to fingers and the majority involve doors. Adolescents experience a higher proportion of more serious amputation injuries. Effective interventions exist but are inadequately used to prevent many of these injuries, including door stops and modifications, bicycle-chain and spoke guards, wearing closed-toe footwear while bicycling, a no-mow-in-reverse default feature on ride-on lawnmowers with the override switch located behind the mower operator, and a SawStop system on power saws. Use of these technical countermeasures and changes in relevant product standards to promote their implementation and use could lead to a decrease in pediatric traumatic amputations.

Accident Prevention↗
PubMed2004

Using a solutions approach.

Companies today are placing an even greater emphasis on keeping all recordable employee injuries to a minimum. A reduction in hand and finger injuries, along with their associated medical and indemnity costs, can have a positive impact on the company's bottom line. Safety actually can provide revenue when the safety program extends beyond the confines of specific product applications. Conducting a careful and complete analysis of all of the critical issues in a company's production process and the procedures in its safety program will allow the organization to identify opportunities for cutting costs while enhancing worker comfort and safety. Identifying business solutions--and not just product applications--will provide organizations with additional cost saving opportunities. Tighter controls, standardization, SKU reduction, productivity improvements, and recycling are just a few of the potential solutions that can be applied. Partnering with a reputable glove manufacturer that offers a critical safety program analysis has the potential to provide numerous, long-term advantages. A business solutions approach can provide potential productivity improvements, injury reductions, standardization of best practices, and SKU reductions, all of which result in a safer work environment.

Cost Control↗
PubMed1999

[Ilio-inguinal-hypogastric vascular network skin flap with common pedicle in the treatment of degloving injury of multiple fingers].

OBJECTIVE: In order to solve the difficult problem of one-stage repair of degloving injury of multiple fingers, the common pedicled ilio-inguinal-hypogastric subdermal vascular network skin flap was designed and the multi-lobes skin flap was performed subsequently. METHODS: From 1993 to 1996, there were 5 cases with degloving injuries of multiple fingers were treated by this flap. There were 2 males and 3 females and the age ranged from 7 to 19 years old. RESULTS: After operation, the pedicles of the flap was detached between 12 to 16 days and all of the flaps survived completely. Patients were followed up for 6-18 months. After repair, the contour and skin colour of the digits were excellent, and the motion of the interphalangeal joints and skin sensation were good. CONCLUSION: The conclusion was as follows: The newly designed skin flap was characterized by the advantages of duration of treatment being short, excellent contour and more rapid recovery of function. It could be used for one-stage repair of degloving injury of multiple fingers.

Adolescent↗
PubMed1995

[Distorsions and dislocations of the finger joints].

Injuries of the finger joints with damage to the capsule and ligaments are quite common. Nevertheless early diagnosis may be missed since patients look for relief only after a period of longstanding pain. A careful clinical and X-ray diagnosis is the prerequisite for appropriate treatment. Surgery is still indicated for most of the injuries of the ulnar ligament of the MP-joint of the thumb. Sprains or dislocations of the middle joint of fingers are quite usual. In most instances they may be treated by immobilisation or functional treatment. Persistent subluxation after reduction of the joint or large avulsion-fractures have to be treated by open surgery. Injuries of the MP-ligaments are frequently misinterpreted. Their treatment should be based on a very careful evaluation of the case.

Finger Injuries↗
PubMed1985

Retardation of finger growth after injury to the flexor tendons.

The absence of any part of the total mechanical force (i.e., flexor tendons) may be responsible for retardation of bone growth during a child's growth phase. The cause of retardation may be dedifferentiation of cartilage cells at the epiphyseal plate. Four cases in which unrepaired flexor tendons in digits caused retardation of growth illustrate this possible phenomenon. We feel that this is not a well recognized problem and thus deserves mention to stimulate further study. We believe that meticulous primary repair in children is desirable not only to preserve function, but also to prevent growth disturbances.

Age Factors↗
PubMed1998

[Acute and chronic overuse injuries in extreme sport-climbing].

From May to September 1994 a study on acute and chronic overuse injuries in to rockclimbing was performed. The etiology of trauma was referred to trainingforms and climbing techniques. 112 climbers participating in the study climbed at level 9+/10- (8a). This study demonstrated that the incidence of overstrain syndromes increased with the performance level. The overall predominance of finger injuries was followed by acute spinal syndromes, knee, and ankle sprains. Among the most frequent overstrain complaints epicondylopathias, chronic complaints of the finger joins and flexor tendons, and nerve compression syndromes of the upper extremities could be seen. Most notable was the fact that the frequency of certain overstrain syndromes increased in relation to the years of climbing.

Adolescent↗