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At least 73 records · Page 4Linked to original sources
PubMed1997

[The value of a hand injury chart].

OBJECTIVE: To assess practicality, clinical merit and usefulness for scientific purposes of a hand injury chart in a hand surgery unit. DESIGN: Descriptive. SETTING: Academic Hospital Rotterdam-Dijkzigt, the Netherlands. METHODS: The records were examined of patients who within the period of one ear required acute surgical therapy for serious hand injuries (n = 148). Data concerning cause and extent of the damage to anatomical structures were recorded to evaluate accuracy in describing a hand injury with and without the chart. Time needed to study the patient record to ascertain sufficient details of the injury was noted in each case. RESULTS: The accuracy in describing a hand injury increased significantly for all anatomical structures except vascular lesions in patient records containing the hand injury chart compared with records without the chart. Using the chart saved one minute of time at the first aid station and the outpatient department. CONCLUSION: The use of a hand injury chart allowed a more accurate and uniform description. The computerized data could be easily used for scientific and audit purposes.

Emergency Service, Hospital↗
PubMed1983

Carotid injury and cerebral infarction in a revascularization hand injury case.

A case of internal carotid artery thrombosis with cerebral infarction occurring in a patient with a massive hand injury is presented. In this case it can be postulated that the mechanism of injury was that of traction of the carotid during the patient's attempts at release of an immobilized extremity. Although the diagnosis of such an injury is difficult, the knowledge that such injuries occur and a suspicion of the examining physician at the time of the initial examination may help avoid such problems in the future.

Adult↗
PubMed1986

The value of a next day hand injury review clinic.

A daily hand injury review clinic takes place at East Birmingham Hospital. The purpose of this study is to determine whether this clinic is beneficial in reducing the morbidity of neglected hand injuries, and to compare the running of the clinic with the original criteria laid down at its inception as a "once only' screening clinic. We conclude that such a clinic is highly beneficial, and recommended that it should be standard practice in other hospitals.

England↗
PubMed1993

The economic impact of hand injuries.

The socio-economic effect of 156 hand injuries was studied prospectively. The average cost per injury was IR 474.28 pounds of the more serious injuries utilized two-thirds of the resources and resulted in 83% of the days lost from work. In the working population approximately 50% of hand injuries occurred at work. In assessing the economic impact of hand injuries, labour costs account for 55 to 65% of costs. Amputation and complicated laceration were the most costly and resulted in more days lost at work. Injuries at work result in greater costs because they involve more serious injuries, and because workers requiring manual skills need a higher level of hand rehabilitation to return to work. Unless the labour costs are taken into account, the true impact of hand injuries is greatly underestimated.

Accidents↗
PubMed2005

Hand injuries in sports medicine.

Many athletic injuries of the hand commonly present to, and can be managed by, primary care physicians. Knowing when to refer is also obviously important. This article is not meant to be an exhaustive list of all possible hand injuries. Rather, it is meant to serve as a useful guide to the primary care physician. For the busy primary care physician, a thorough assessment of the hand or wrist complaint includes a focused history and physical and the judicious use of supportive diagnostic testing. Know your anatomy and sport. This will set the foundation clinically for the best possible outcome. Ultimately,the goals of assessment and management are to restore, maximize, and preserve function.

Athletic Injuries↗
PubMed2005

[Operative strategies for hand injuries in multiple trauma. A systematic review of the literature].

OBJECTIVE: Hand injuries are not life threatening but crucial in multiple trauma because of their long-term functional results. The goal of this systematic review was to derive recommendations for diagnostic and treatment procedures from a systematic review of the literature. METHODS: Articles on hand injuries in multiple trauma and articles on clinical trails for isolated hand injuries were systematically collected (MEDLINE, Cochrane, and hand searches) and classified into evidence levels (1 to 5 according to the Oxford system). RESULTS: The special management of hand injuries in multiple trauma requires accurate diagnostic procedures, differentiated therapy strategies, and adequate timing. Depending on type and extent of the injury, there are substantial differences for primary or secondary operative treatment. CONCLUSION: Hand injuries represent important lesions in multiple trauma. Due to the life-threatening situation they may be overlooked in the beginning of the treatment. Because of their long-term consequences for function and health-related quality of life, hand injuries require an early and accurate diagnosis and a differentiated treatment strategy.

Clinical Trials as Topic↗
PubMed1998

[Surgical anatomy with special reference to reconstruction in severe hand injuries].

The treatment of mutilating hand injuries demands exact knowledge of the anatomy of the hand. Minor faults in the operative treatment may lead to severe permanent functional impairment of the hand. Today, primary reconstruction of all injured structures is performed. The aim is reconstruction of function as well as cosmesis of the hand. The principle components of reconstruction are: position, prehension, sensibility, trophic, and cover of the hand.

Esthetics↗
PubMed1986

Psychological evaluation of patients with industrial hand injuries.

Psychological evaluations with hand injury patients provide diagnostic information and treatment recommendations that can be included with the findings from physical and neurologic examinations. Assessment of psychosocial factors that can either complicate recovery from injury or aid in rehabilitation is discussed. Four clinical cases are presented.

Adult↗
PubMed1992

Predictive value of psychological screening in acute hand injuries.

Difficulties in adjustment frequently accompany severe hand injuries. The purpose of this study was to determine whether presurgical screening could predict long-term adjustment problems. One hundred thirteen patients with severe hand injuries completed a presurgical questionnaire evaluating flashbacks, avoidance, and causal factors pertaining to the injury. Patients were evaluated by a psychologist within 5 days after surgery and again 6 months later. Flashbacks initially occurred with equal frequency in occupationally and nonoccupationally injured groups. At 6-month follow-up 50% of the occupationally injured patients and 25% of the nonoccupationally injured patients had flashbacks. Avoidance of the activity at which patients were injured was also assessed. Among occupationally injured patients, 52% initially reported no avoidance compared with 17% at follow-up. Patients with nonoccupational injuries showed more initial avoidance (68%), with slightly less at follow-up (61%). Of the occupationally injured patients, 46% initially reported personal error or fatigue as the cause of their injury, but only 6% reported this as the cause at follow-up; it is interesting that at 6-month follow-up 81% of this group reported machine failure or lack of safeguards. Among nonoccupationally injured patients, 71% reported personal error as the cause of injury presurgically and 66% at 6-month follow-up. Presurgical screening appears to be a valid means of identifying persons at risk of ongoing adjustment problems after hand injury. A screening interview can easily be conducted in less than 5 minutes.

Accidents, Occupational↗
PubMed1993

Hand injuries in children presenting to a pediatric emergency department.

STUDY OBJECTIVE: To study the epidemiology of pediatric hand injuries. DESIGN: Retrospective chart review. SETTING: Emergency department of a children's hospital. PARTICIPANTS: All patients with a final diagnosis of hand injury from July through December 1989. INTERVENTIONS: None. RESULTS: Four hundred sixty-four patients (287 boys and 177 girls; median age, 10 years) with a total of 477 hand injuries were enrolled in the study. The most common types of injuries were lacerations (38.1%), soft tissue injuries (28.7%), and fractures (19.3%) and sprains (8%); most (60.8%) were sustained at home. Children with lacerations and burns were significantly younger than those with other types of hand injuries (P < .0001). Children with fractures, sprains, and sports injuries were significantly older than those with other types of hand injuries (P < .001). The fifth finger was the most commonly fractured digit (37%), and the fifth metacarpal was the most commonly fractured bone (P < .01). Boys were more likely than girls to sustain sports-related injuries (P < .05) and hand injuries resulting from first fights (P < .01). More hand injuries were associated with football than with any other organized sport (P < .01). All but 16 children (3.4%) were managed as outpatients. CONCLUSION: Hand trauma accounts for a significant number of pediatric ED visits. Physicians caring for children in the ED setting must be prepared to manage a wide spectrum of pediatric hand injuries.

Adolescent↗
PubMed1987

Beyond replantation: microsurgical salvage of complex hand injuries.

The authors believe that certain complex hand injuries so severe as to be considered for amputation or simple proximal revision, may under some circumstances be salvaged with the use of appropriate microsurgical techniques. They present three examples of severely injured hands to illustrate the reconstructive potential of microsurgery. Salvage techniques are considered in some detail including debridement, evaluation and planning, fixation, restoration of circulation, reconstruction of tendons, joints and nerves, and provision of coverage. The importance of vein grafts for successful salvage of complex hand injuries is emphasized.

Adolescent↗
PubMed1994

[Hand injury in polytrauma. A retrospective study of 782 cases].

The incidence of hand injuries in multiple trauma is not well investigated. Between 1980 and 1986, 782 multiple trauma patients received primary treatment at the University Hospital of Erlangen. At the time of the study, 22% (n = 173) of these patients had died. 93% of the patients met with a traffic accident. In 20% of the multiple trauma patients, additional hand injuries were seen. 75% of these injuries were closed fractures of hand and wrist. The severity of multiple trauma had no influence on the incidence of hand injury. Young people between twenty and fourty years of age were mostly affected in multiple trauma, with increased incidence of hand injuries especially after motorcycle accidents. Delay of diagnosis of hand injuries was rare.

Adult↗
PubMed2004

The epidemiology of hand injuries in The Netherlands and Denmark.

Little is known about the magnitude of hand injuries at national levels. This paper quantifies and characterises the incidence of hand injuries that require acute medical attention at Emergency Departments in The Netherlands and Denmark. Except for the incidence rate and the referral after treatment, the overall picture of hand injuries is similar for both countries: hand injuries show a peak for teenagers, result mainly from home and leisure accidents, are mainly caused by objects and falls, the majority affect fingers and result mainly in superficial injuries, open wounds and fractures, a small proportion of the victims is admitted into hospital. We conclude that hand injuries are a real burden to society and are worthwhile to be prevented with special attention for home and leisure accidents and occupational accidents. Data recording on the backgrounds of accidents and their long term consequences should be improved.

Accidental Falls↗
PubMed1993

Hand preference and the incidence of accidental unilateral hand injury.

Four hundred and eighty-six individuals gave detailed descriptions of an accidental unilateral hand injury and answered questions about their hand preference. Their handedness data were compared to 402 respondents (matched for sex and age) with no experience of hand injury. The risk of hand injury was similar for right- and left-handers. Individuals with consistent hand preference, regardless of side, were more likely to injure their preferred hand when compared to mixed preference types. The present data argue for a use explanation of hand injury risk (one is more likely to injure the hand that is used most frequently) rather than an explanation based on inherent risk factors present for left- but not for right-handers.

Accidents↗
PubMed1998

[Trade-specific occurrence of occupational hand injuries].

The purpose of the investigation was to estimate the trade-specific incidence of occupational hand injuries, to estimate the trade-specific cumulative incidence proportion and to investigate whether age, gender and trade each were independent risk-indicators for occupational hand injuries. In a retrospective design, 823 patients with occupational hand injuries treated at Odense University Hospital were included in the investigation. The population at risk was 96,512 persons engaged in active employment within the municipality of Odense. The overall incidence of occupational hand injuries was estimated to 1.7 percent and 0.3 percent for significant injuries. The incidences in the production- and building industries were significantly higher than the incidence in the service industries. Gender and occupation were both found to be independent risk-indicators for occupational hand injuries, age only for the minor injuries. Occupational hand injuries seem to be so common, that prevention-trials should continuously be intensified. The target-groups should firstly be employees in the production industries, however prevention-trials directed against specific age- and gender behaviour patterns should also be considered.

Accidents, Occupational↗
PubMed1996

[Injuries caused by motorized lawn mowers--hand injuries the most common ones].

The powerful forces involved in the function of motorized lawnmowers can cause serious injuries. The study reported was based on a series of 81 cases of injury, that were treated at University Hospital, Umeå. Direct trauma to hand and foot was the most common injury mechanism, though high energy expulsion of objects from the machine was not uncommon. A common cause of direct trauma to hand or foot was attempting to clear grass or other matter from the vicinity of the rotating blades. Hand injuries were most common and occurred predominantly in men, whereas women and children accounted for a greater proportion of missile injuries instead. 25 per cent of all hand and foot injuries were amputating fractures. The preventive measures that could and should be implemented to reduce the risk of these injuries include improved shielding of rotating and heated parts, prevention of missile ejection, and the introduction of dead-man grip. The use of protective gear, and greater care in the use of motor mowers generally, would also reduce the risk of injury.

Accidents, Home↗
PubMed1986

Iatrogenic hand injuries in outpatients.

Potentially serious iatrogenic hand injuries occurred in three patients in a general medicine practice. All resulted from technologic advances in patient care. Each resulted in substantial economic and emotional costs. One patient sustained a serious residual disability. Such injuries have rarely been reported in the past, but advances in medical technology and changes in reimbursement patterns may make outpatient iatrogenic hand injuries increasingly common. Physicians must be alert to such injuries.

Aged↗
PubMed1976

Quantitative microbiology: its application to hand injuries.

Quantitative microbiologic analysis of civilian hand injuries has been accomplished in thirty-four patients. Most traumatic soft tissue injuries exhibited an insignificant level of contamination. The number of bacteria recovered from most of those wounds was comparable to that encountered in clean elective surgical hand cases. We now view most civilian hand wounds as clean wounds carrying a very low risk of infection. Our patients with traumatic hand injuries are considered candidates for immediate reconstruction, which includes vascular, bony, or neural repair as well as immediate implantation of Silastic rods in preparation for subsequent tendon grafting.

Bacteriological Techniques↗