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At least 865 records · Page 48Linked to original sources
PubMed2006

Risks for, and causes of, injuries to the hand and forearm: a study in children 0 to 6 years old.

Ninety-six children aged 0-6 years with unintentional hand injuries were referred to the Department of Hand Surgery between 2002 and 2003. Either parents, medical staff, or both, completed a questionnaire (response rate 79/96; 82%) about the circumstances of the injury. The incidence of injuries referred for treatment was 33.4/10,000 people/year. Seventy-five percent (59/79) of all injuries occurred at home, and only 8% (6/79) in a day-care centre. The risk was highest between 4 p.m. and 8 p.m. (incidence rate ratio 5.17, 95% confidence interval 2.12 to 17.7) and in 6 year old children (IRR 4.89, 95% CI 1.58 to 37.68). Adults were present when 66/79 children (84%) were injured. Most injuries occurred during play (39/79; 49%). Stuck in front doors (23/79; 29%) (closed by a child) was common. There was no increase in incidence in children with a foreign background (IRR 1.19, 95% CI 0.64 to 2.28). Advice about prevention will be distributed to parents to encourage safer environments in homes.

Accidents, Home↗
PubMed1992

Hand tendon injuries in athletics.

Hand tendon injuries may be caused by acute trauma or chronic overuse. Although these injuries are common in athletics, specific diagnoses can be difficult to make and are often delayed. Early diagnosis is the key to a good outcome. Most hand tendon injuries do well with nonoperative treatment when initiated early. Long-term disruption of the delicate balance of muscle forces in the hand will lead to secondary changes that are often difficult to correct. Delay in treatment of overuse injuries may produce chronic inflammation that does not respond to conservative care and requires operative management. A sound knowledge of hand anatomy, awareness of the differential diagnosis, and a high index of suspicion are needed for proper care of the athletic hand injury.

Acute Disease↗
PubMed1997

The "Tic-Tac-Toe" classification system for mutilating injuries of the hand.

Several classifications of mutilating hand injuries exist in the literature. Unfortunately, each of these provides a categorization that is arbitrarily grouped according to the part of the hand predominantly involved. It is imperative that a comprehensive classification system incorporate the degree and precise location of soft-tissue and/or bony destruction and the vascular integrity in addition to the predominantly involved part of the hand. We therefore devised a new classification system for mutilating injuries of the hand which categorizes them into seven types: (I) dorsal mutilation, (II) palmer mutilation, (III) ulnar mutilation, (IV) radial mutilation, (V) transverse amputations, (VI) degloving injuries, and (VII) combination injuries. These types are subcategorized into three subtypes: (A) soft-tissue loss, (B) bony loss, and (C) combined tissue loss. Vascular integrity is recorded with subscript notation: (0) vascularization intact or (1) devascularization. The hand is then systematically divided into nine numerical zones in "tic-tac-toe" fashion with radial, central, and ulnar columns and proximal, central, and distal rows. The "Tic-Tac-Toe" classification system allows the examining surgeon to describe precisely any mutilating injury of the hand. This system permits accurate assessment of each hand injury by assignment of the appropriate classification type, subtype, vascular status, and zone involvement. Clinical examples illustrate the user-friendliness and practicality of this new classification system.

Adolescent↗
PubMed1988

Mutilating corn-picker injuries of the hand.

Our experience with 15 patients who had acute mutilating hand injuries from corn-picker machines is reviewed. Three injury patterns were defined. Type I involved severe injury to all digits of the hand, including the thumb; type II injuries involved amputation of all fingers, in whole or in part, but with sparing of the thumb; and type III injuries involved amputation of multiple fingers with sparing of the thumb and at least one other digit. Attempts at revascularization or at complex reconstruction of the injured digits in the period immediately after injury failed in all 15 patients. The most satisfactory results in patients with type I injuries were obtained by complex reconstructive procedures such as toe-to-hand transfer. Patients with type II injuries were best treated with construction of a mitten-type hand by various methods. Patients with type III injuries were best treated by amputation of the devascularized digits.

Accidents, Occupational↗
PubMed1993

Injuries to the hand in rugby union football.

Hand injuries are a common consequence of playing rugby. A prospective study of all rugby injuries referred to a hand clinic over the course of one season was carried out. 72 patients with such injuries were seen. There were 46 fractures and 26 soft tissue injuries. A substantial number were caused deliberately by opponents. One-third of the injuries were thought to be preventable.

Adult↗
PubMedDate not supplied

Persistent mechanical allodynia following injury of the hand. Treatment through mobilization of the nervous system.

Mechanical allodynia (MA) following hand injury is a well-documented clinical problem. The purpose of this pilot study was to examine the relationship between hand MA and the upper limb tension test (ULTT). The ULTT mechanically stresses the neural structures from the C5/6/7 neural foramina to the median nerve distally. This study examined 29 subjects with unilateral hand MA before and after a 2-week neural self-mobilization programme. There was a significant difference between the subjects' affected and unaffected sides when tested using the ULTT, both in reproduction of symptoms and in reduced range of motion of the ULTT. Following the self-mobilization program, there was an improvement in the range of the ULTT, and subjects reported a reduction in their symptoms. Complete recovery was not obtained in all cases. The results of this study suggest that the ULTT is a useful tool both in assessment and treatment of subjects with hand MA.

Adult↗
PubMed1997

Snowblower injuries to the hand.

We retrospectively reviewed the records of 62 patients who sustained serious hand injuries caused by snowblowers between 1981 and 1990. Frequency of injuries to digits tended to correlate with length (i.e., middle, index, ring, or small finger or thumb). Damage to tendons did not seem to follow any particular pattern. The majority of victims sustained multiple digital involvement. Complete versus partial amputation followed the same length distribution as did injured digits. Most of the injuries occurred to the dominant hand. When patients were further questioned regarding the circumstances and events leading to their injury, a recurring pattern was found. Most patients described a wet, heavy snow having recently fallen. The majority of the patients who were injured by placing their hands into the exit chute admitted that they were aware the machine was running, but thought that they had a greater clearance to the rotating impeller blade.

Accidents, Home↗
PubMed1981

Log splitter injuries to the hand.

Use of the powered log splitter in processing wood for fuel has emerged as an important source of disabling hand injury in the Vermont area. Thirteen such injuries are reviewed and two representative cases are presented. Physicians are advised of this new mechanism of injury and the public is warned of the danger in using these machines.

Accidents, Occupational↗
PubMed1983

Acute management of foreign body injuries of the hand.

A review of the identification of foreign body hand injuries is presented with criteria for removal of a foreign body in the emergency department. Indications for acute surgical intervention are presented, and expectant management is discussed.

Emergencies↗
PubMedDate not supplied

High-pressure injection injury: a hand-threatening emergency.

A variety of tools mounted with high-pressure nozzles cause a typical pattern of hand injuries. Often the relatively mild initial symptoms conceal the actual degree of tissue damage and the need for prompt treatment. As illustrated by a case of dye impression, early extensive surgical exploration and radical removal of the injected agent are mandatory to minimize sequelae and to avoid mutilating complications. Pathophysiology and surgical management of this hand-threatening emergency are outlined.

Accidents, Occupational↗
PubMed1990

[Primary and secondary soft tissue injuries of the hand and therapeutic possibilities].

Primary treatment of soft tissue hand injuries is most important for further management and progress. It ensures best protection of lower structures. Soft tissue lesions that can not be closed without resulting tensions need instant plastic-surgical therapy. Various possibilities that range from split skin flaps to distant flaps with microvascular anastomosis can be chosen to cover primary as well as secondary soft tissue defects.

Hand Injuries↗
PubMed1975

Skin and soft tissue injuries of the hand in children.

Three pediatric hand injury subtypes and their management have been presented. Finger tip injuries, while often minor and self-healing in children, may require surgical repair if the nailbed is disrupted or if there has been significant skin or pad loss from the tip. The decision between local repair and skin graft or pedicle reconstruction depends on the nature and extent of the injury. Multiple digit injuries should be carefully evaluated and manged with a view toward retention of digit length and restoration of function. Immediate closure of all wounds, while desirable, is not necessary. Minor hand burns are quite easily managed but burn injuries more severe in extent and/or depth must be treated with careful attention to detail. Splinting and elevation of the hand, early incisional decompression, the institution of early and diligent active motion and expeditious wound closure with skin grafts where full thickness loss has occurred will hasten the time of healing, minimize deformity and assist in the recovery of normal hand function.

Accidents↗
PubMed1990

[Gunshot and explosion injuries of the hand].

The problem of hand injuries from bullets and explosives is covered in this paper by the example of three cases. The recommendation is made to remove only easily accessible projectiles. The damage caused by the intervention must not be larger than that caused by the bullet injury. Essential measures should include immediate wound toilet with removal of devitalised tissue, primary osteosynthesis, preferentially with minifixateur externe, coverage of exposed tendons, nerves, bones, and joints, splitting of the ligamentum carpi volare, perioperative administration of antibiotics, and secondary skin suture. Definite treatment should be left to a centre of hand surgery.

Adult↗
PubMed1989

Injuries to the hand inflicted by rotary snowcutters.

In the period January 1, 1975, through December 31, 1986, 28 patients were treated for hand injuries caused by small home rotary snowcutters. These injuries were characterized by extensive lacerations and contusions, particularly on the dorsal side of the hand and the fingers, with concomitant extensor tendon ruptures, comminuted and complicated fractures, and traumatic amputations of fingers of the dominant hand. The index and middle finger were nearly always injured; the thumb was usually totally spared. The frequency of postoperative complications was low after delayed primary surgical treatment. In this series the mean permanent medical disablement was found to be 12%, ranging from 0 to 50%. The present observations, when made available, alarmed national authorities. In turn, manufacturers were required to equip rotary snowcutters with motorquenchers. This device will probably effectively prevent these injuries in the future.

Accidents, Home↗
PubMed1991

Radiographic imaging of foreign bodies in the hand.

Injuries involving foreign bodies in the hand are common. Index of suspicion should be high in any hand injury, particularly with a proper history. Plain radiographs should be obtained liberally and multiple views always taken. Xeroradiography, if available, is helpful if the plain radiographs are normal and a foreign body is suspected. Ultrasound is useful particularly in the detection of non-radiopaque foreign bodies and can provide guidance for removal of foreign objects if they are not readily found at surgery. Computed tomography (CT) and magnetic resonance imaging (MRI) may be used in rare instances if other studies have failed to detect a suspected foreign object, particularly a small wood or wood-like fragment. CT and MRI are the best studies to evaluate complications of retained foreign bodies.

Foreign Bodies↗
PubMed1980

Pitfalls in management of fingertip injuries and hand lacerations.

Fingertip injuries and lacerations of the hand are often dismissed as inconsequential, although this attitude can lead to more serious problems. Appropriate and timely treatment of these injuries prevents loss of function, preserves digital sensibility, and lessens the need for reconstructive surgery.

Adolescent↗