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PubMed1998

Rehabilitation and use of protective devices in hand and wrist injuries.

Hand and wrist injuries are common among athletes. Although the hand does not often bear weight and these injuries do not always sideline an athlete, careful attention must be paid when treating injuries of the hand and wrist. Rehabilitation is given for common injuries of the hand and wrist, including exercises and protective splints and braces. Details on how to fabricate a playing cast for athletes are also discussed.

Athletic Injuries↗
PubMed2000

[Flexor and extensor tendon injuries of the hand].

Injuries of the flexor tendon are usually open injuries. In most cases primary treatment is therefore seldom performed by orthopaedic surgeons. This is different for injuries of the extensor tendon. Three quarters of injuries of the extensor tendon are closed injuries. Therefore we do go into primary and secondary reconstruction of the flexor tendon, but focus on primary and secondary reconstruction of the extensor tendon in the most common zones (1, Th I, 3, Th III).

Finger Injuries↗
PubMed1989

Frostbite injuries of the hand.

Injury from frostbite has had a profound effect on developing civilizations and continues to affect modern day humans. Rational therapy and future research for frostbite must be based on a comprehensive understanding of the physiology of tissue freezing and healing. Therapy directed toward maximizing the likelihood of secondary healing is divided into field, emergency department, and nonacute management.

Child↗
PubMed2003

Infectious complications associated with toothpick injuries of the hand.

PURPOSE: Although rare, hand injury caused by toothpicks can result in serious complications similar to hand injury produced by human biting. To emphasize its clinical significance this article describes a group of patients sustaining hand injury induced by toothpicks. METHOD: Eight patients who developed cellulitis, abscess, septic arthritis, and/or pyogenic tenosynovitis of flexor tendons after toothpick injuries of the hand were treated at our hospital. Seven of them required admission for antibiotics and surgical treatment. RESULTS: The 7 admitted patients required multiple debridements (3 times on average) to control infection and administer intravenous antibiotics for mixed aerobic and anaerobic infections showing in wound cultures. The average hospital stay for the 7 patients was 26 days. At follow-up evaluation, 4 patients had full recovery of hand function after various cutaneous flap resurfacing of the wounds or staged tendon reconstruction, whereas the remaining 4 patients had arthritis with flexion contracture of interphalangeal joints or persistent paresthesia of the finger. CONCLUSIONS: Patients injured by contaminated toothpicks should be treated with antibiotics that inhibit the growth of both aerobic and anaerobic organisms immediately after these organisms have been identified from cultures. Moreover early surgical treatment might avoid complications and obtain satisfactory results.

Adult↗
PubMed2005

Dough sheeter injuries to the upper limb: severity grading and patterns of injury.

BACKGROUND: Hand injuries by roller machines are not uncommon. Short mentions in textbooks describe them as severe. Injuries by dough sheeter machines, an example of roller trauma, are treated frequently in the authors' practice. No reports on lesions specifically caused by sheeters were found. METHODS: This study retrospectively analyzed 28 consecutive cases. Causes of accidents and injury patterns were described, and severity was graded by the Hand Injury Severity Score. RESULTS: Injury patterns were referenced to anatomic components. Integument (24 cases) and skeleton (14 cases) were the most frequently injured, whereas tendons and nerves were the least frequently injured. Hand Injury Severity Score values ranged from 4 to 182 (mean, 75.36). Only two cases qualified as mild. The remaining cases fell into the moderate, major, or severe categories. In three cases, the Hand Injury Severity Score was not applicable. CONCLUSIONS: As a rule, sheeter accidents cause serious injuries. Integument and bone traumas are predominant. Simple safety practices could prevent most of these injuries.

Accidents, Occupational↗
PubMed2005

The significance of extensor tendon tethering and dorsal joint capsule tightening after injury to the hand.

This paper examines the clinical problem of extensor tendon tethering and/or dorsal joint capsule tightening secondary to hand injury. One hundred and forty-one patients were examined 13 to 51 months after hand injuries of varying severity. Fifty-six patients (40%) had suffered simple and eighty-five patients (60%) complex injuries. Seventy-four (52%) of the 141 patients had no extensor tendon tethering and/or dorsal joint capsule tightening. In 30 (21%), the extensor tendon tethering and/or dorsal joint capsule tightening was considered to be "obvious" in that it was easily seen on examination using various commonly used clinical tests of finger flexion and extension. In 37 (26%), the extensor tendon tethering and/or dorsal joint capsule tightening was considered to be of "lesser degree" because it was only evident on application of specific tests which are described in this paper. Of the 37, 21 (56%) described themselves as being unable to make a "proper" fist with the injured hand, 33 (89%) had pain or discomfort on the dorsum of the injured hand and/or fingers on gripping (P < 0.01) and 25 (70%) had weakness of power of gripping (P < 0.01). Thirty-two (87%) complained of functional problems at work, with activities of daily living or with the pursuit of their hobbies.

Activities of Daily Living↗
PubMed1994

Hand infections secondary to fish bone injuries.

Hand injuries associated with fish bones and fin spines are not common but can cause morbidity out of proportion to the original injury. This is because such injuries often leave residual fragments of foreign organic matter in the tissues, leading to troublesome secondary infections. This report details 1 year's experience with nine hand infections after fish bone injury in a busy regional hand surgery referral centre. There were five males and four females with an average age of 45 years. Radiographs taken on presentation in five patients revealed a radiolucent foreign body in only two patients. Two patients presented with a flexor tendon sheath infection, three with a pulp space infection, one with infection of the hypothenar space, one with a subungual infection, one with cellulitis of the dorsum of the hand and one with an abscess on the dorsum of the hand. Antibiotics were prescribed for six patients and all patients except the one with cellulitis of his hand underwent surgical débridement. A single surgical procedure was adequate in five patients. One patient with a hypothenar space infection only had the foreign body removed during the third surgical débridement. The two patients with flexor tendon sheath infections required ray amputation. Fish bones cause a number of different infections in the hand. A foreign body should always be sought even if not present on the radiograph. Antibiotic selection should be tailored to eradicate the causative organism.

Adult↗
PubMed1991

[Restorative treatment of blast injuries of the hand in children].

The experience of surgical treatment of children with the most grave hand injuries is presented. The authors consider that the restorative treatment is to begin from the moment of initial surgical processing of the explosive hand injuries. Three periods of treatment have been singled out. Each of them has its own objects and tasks. Logical combination of surgical treatment stages allows for maximum restoration of form and function of an injured hand during the shortest possible time and with the minimum losses for a patient.

Adolescent↗
PubMed1975

High-pressure silicone injection injury of the hand.

A case of room-temperature vulcanizing (RTV) silicone injection of the hand is presented, and principles of management of high-pressure hand injuries are outlined. Early debridement and decompression are urgent in the acute stage of injury. Intermediate stages require adequate coverage and mobilization, and late stages involve reconstructive procedures. As in all high-pressure hand injuries, safety measures and prevention at the industrial level are very important.

Adult↗
PubMed1991

Firework injuries to the hand.

Hand injuries by fireworks occur every year especially around New Year's Eve. These complex injuries show a combination of avulsion, laceration, blast, crush and burns. Three typical cases are presented and their treatment is outlined.

Adolescent↗
PubMed1979

Moulding press injury of the hand.

This paper reports pattern of hand injuries caused by Moulding Press Machine. A classification of the injuries to provide guideline to the management and prognosis is outlined.

Accidents, Occupational↗
PubMed1997

[Fireworks-caused injuries in Denmark].

The number and type of fireworks injuries occurring around New Year's Eve as well as type of fireworks used was investigated with the aim of guiding future prophylactic efforts. All patient contacts to emergency rooms throughout Denmark that were due to fireworks were prospectively registered for twenty-four hours before and after New Year's Eve 1995/1996 and 1996/1997. The number of fireworks injuries increased by 13.9% from 381 to 433, and the number of serious injuries increased by 50.8%. In 1996/1997 50% of the injuries were hand injuries, 19% were eye injuries, 8% were injuries to the head and neck, and the remaining 23% were hearing injuries and miscellaneous injuries. Seventy percent of the serious injuries were hand injuries, leading to some form of amputation in a third of cases. Sixty-one percent of the admissions were due to illegal fireworks. It is concluded that the number of serious fireworks injuries is on the increase, and that the main part of these injuries are hand injuries. Over half of the the serious injuries were due to illegal fireworks. Prophylactic efforts should be aimed against hand-held and illegal fireworks.

Adolescent↗
PubMed2005

Prospective study of patients with injuries to the hand and forearm: costs, function, and general health.

Patients with injured hands and forearms of varying severity [Hand Injury Severity Score (HISS)] were studied prospectively, including analysis of costs, hand/arm function (DASH), and health status (SF-36). Costs, duration of sick-leave, DASH-score (high score; impaired function) increased by severity of injury (higher HISS) and the greatest proportion of total costs resulted from lost production. Most employed patients returned to work within a year, but even minor injuries were expensive. HISS and costs of care during an emergency were significantly associated with duration of sick-leave, although HISS did not fully explain variation in costs and duration of sick-leave. DASH-score at one year was associated with variation in age, HISS, and residual health care costs. Results of DASH and subgroups for physical and bodily pain on SF-36 were consistent. Injuries to hand and forearm may generate high costs for society in terms of health care and long periods of sick-leave (lost production), but even minor injuries should be accounted for.

Accidents↗
PubMed1989

Office management of athletic injuries of the hand and wrist.

Most common hand injuries occurring in athletics can be simply treated and the athlete returned to participation at an early date. Delayed or inadequate treatment may result in an unacceptable outcome, including permanent deformity. The injured athlete must be carefully examined, treated, and monitored until fully rehabilitated.

Athletic Injuries↗