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PubMed1981

Hand injuries in Finland.

The study is based on patients with hand injuries treated in the casualty department of Turku University Central Hospital during the years 1971-75 and 1978; there were 4 800 of these patients annually. Hand injuries accounted for 26% of all accidents. Of these patients, 14% were younger than 15, 78% were of working age and only 8% were over 65. Of the adult patients, 3/5 were men. The average age of the men was 35 and of the women 45. Calculated on the basis of our material, the annual number of hand injuries requiring medical attention in Finland was 33 000/10(6) inhabitants. Most hand injuries among adults, 70%, occurred in the home, 28% at work and only some 3% in road accidents. Lacerations of varying degrees of severity constituted 45% of the injuries, fractures 26% and lesser contusions, excoriations and distortions 20%. There were relatively few serious injuries, e.g. 2% of the cases were nerve and tendon lesions; however, the actual workload caused by these injuries was considerable.

Accidents, Home↗
PubMed1986

Risk factors for occupational hand injury.

A case-control study of occupational hand injury was conducted in an effort to identify risk factors for disabling injury. Case employees in this study were municipal employees who had sustained restricted activity or lost work time as a result of hand injuries while at work. Each case employee was individually matched to a control employee of the same sex who held the same job and was at work on the same date and shift that the case employee's injury occurred. A conditional logistic regression model was used to adjust for confounding variables. Performing a task that was not a usual job requirement, using defective materials, presence of cardiovascular disease, sleeping nine or more hours per night, and being less than 25 years of age were identified to be risk factors after adjustment.

Accidents, Occupational↗
PubMed1994

Mutilating shredder/chipper hand injuries.

Outdoor recreational and vocational hand injuries occur with a predictable seasonal fluctuation and regional variation. An increasing demand in less urban areas for efficient yard and garden waste removal, combined with the availability of more affordable shredder/chipper machines, has increased their utilization. Potential hazards have been well recognized, but, not surprisingly, this behavior pattern has concomitantly introduced another characteristic syndrome of self-inflicted operator injury most prevalent in the fall and spring months. The seriousness of the possible upper extremity mutilation caused by these devices cannot be understated, as invariably, complex reconstruction modalities are essential to restore a useful hand.

Accidents, Home↗
PubMed1988

Flashbacks after traumatic hand injuries: prognostic indicators.

Flashbacks of a traumatic hand injury may compromise a patient's rehabilitation process. This study examined the nature and significance of these flashbacks in a work-injured population. We also evaluated the ability of these patients to return to work at the site of the original injury. Sixty-one patients with work-related, traumatic hand injuries received psychological evaluation and treatment. All patients experienced flashbacks. The following three types of flashbacks were identified: (1) a replaying of the events occurring just before the accident and continuing until the injury (replay flashbacks), (2) an image of the injured hand just after the trauma occurred (appraisal flashbacks), and (3) images in which an injury that was more severe than the one that actually occurred were perceived (projected flashbacks). Regardless of the result of injury, patients with replay flashbacks were the most likely to return to their former employment (95.2%) after only 4.8 1-hour sessions of psychotherapy for control of symptoms. Patients with a combination of appraisal and projected flashbacks were the least likely to return to work (10.3%), despite the fact they received an average of 13.1 1-hour sessions of psychotherapy.

Accidents, Occupational↗
PubMed2003

Outcomes after mutilating hand injuries: review of the literature and recommendations for assessment.

The functional outcome of a mutilating hand injury cannot be fully assessed at the time of injury alone. The measure of functional outcome must incorporate the evaluation and severity of the initial injury and the subsequent reconstructive surgeries. The complexity of the hand deserves no less. Restoration of prehensile function is the top priority in reconstruction following mutilating hand injuries, and assessment of outcome should address this goal. Flaps and specialized tissue grafts can restore architecture and balance in the hand. One can reconstruct a thumb and fingers with the big toe and smaller toes to give a functional sensate grip. The assessment of functional outcome should include not only objective measures but also subjective questionnaires that focus on issues most relevant to the patient. The use of questionnaires that have been shown to be valid, reliable, consistent, responsive, and sensitive allows the most meaningful conclusions about and comparisons between treatments. Perhaps because of the unique challenges presented by mutilating hand injuries, a new instrument, specific to mutilating hand injury, may provide the most beneficial information to guide treatment and assess outcome.

Hand Injuries↗