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An inside look: hand injury-prevention program.

The purpose of this article is to review the development of an industrial hand injury-prevention program to provide the impetus for other hand therapists to undertake such programs. The article includes a description of how to initiate a prevention program, the content of the training seminar, presentation methods, and marketing strategies. The "Handle with Care" program was effective in reducing the cost and incidence of industrial hand injuries and was favorably received by Oklahoma industry at its inception. A new program is currently being developed in California.

Accidents, Occupational↗

[Surgical approaches in the treatment of burns].

The indication for operative treatment of third-degree burns, necrectomy and the possibilities for closing the defects are discussed. Special problems have to be considered in the operative therapy of third-degree hand injuries. In cases of extensive burns the donor areas are mostly limited and a biological dressing must be used. Different kinds of wound coverage are available for the final autologous skin reconstruction in these patients. Last but not least, the right postoperative immobilisation of both the patient and the transplanted areas is very important for successful skin grafting.

Biological Dressings↗

[Experience of application of skin flap in repairing 112 patients with severe thermo pressure injury of hand].

OBJECTIVE: To investigate the clinical effect of skin flaps repairing severe thermopressure injury of hand. METHODS: From January 1989 to December 1998, 112 patients with severe thermopressure injury of hand were repaired by various skin flaps transfer, the size of skin flaps was 6 cm x 8 cm to 12 cm x 18 cm. Postoperative patients were treated by combined rehabilitation in early stage. RESULTS: All the flaps were survived with satisfactory effect. Sixty-six patients were followed up 6 to 12 months, skin flaps all showed better colour and texture, and function of the hand was satisfactory. CONCLUSION: Different skin flaps are adopted to repair severe thermopressure injury of the hand according to different skin defects of the hand, combined early rehabilitation treatment, to achieve good recovery of function and appearance of the hand to the greatest extent.

Adolescent↗

Explosion injuries of the hand. Spatial relationship and injury pattern.

Twenty-six hands in 25 male patients were treated for peace-time explosion injuries of the palmar aspect. All patients were examined after a mean interval of 7 (1-17) years. In order to establish a regional pattern for each injury the palmar surface of the hand was divided in 21 fields. For each field a score depending on the extent of injury was calculated. Comparing this regional score with the spatial relation between hand and exploding object resulted in six typical patterns depending on the grip during explosion. With knowledge of the three-dimensional relation between the hand and exploding object, the hand surgeon is prepared for potential problems during operation.

Adolescent↗

Wrist and hand skeletal injuries in children.

When accidents occur, the hand is the part of the body most often thrust out to lessen the consequences, resulting in a wide array of combinations of soft-tissue and chondro-osseous injuries. Pediatric wrist and hand skeletal injuries discussed in this article include growth mechanism injury, fractures and dislocations, nailbed injuries, fingertip injuries, burns, and frostbite.

Child↗

Grease burns of the hand: preventable injuries.

Grease burns to the hand represent a serious and preventable hazard. These injuries account for over 10% of all major burns seen in the emergency department. These burns occur when the cook attempts to move a pan with burning cooking oil and inadvertently spills the oil on the hand holding the pan. These burns are usually full thickness because of either the high temperatures of the flaming oils or the subsequent ignition of clothing. This article describes a patient who received severe partial and full thickness burns to the dominant hand following a grease burn in the domestic setting. Prevention through improved consumer education and warning labels for cooking oils should reduce the incidence of these serious injuries.

Accidents, Home↗

Management of neuromas in the hand.

Injury to a peripheral nerve in the hand can result in loss of motor and sensory function. In addition, incomplete or abnormal regeneration can cause painful sequelae. The approach to neuromas in the hand requires familiarity with the basic aspects of nerve regeneration as well as the neurophysiology of pain mechanisms.

Hand↗

[Skin flaps for repairing hands with severe burn and compression injuries in the hand].

OBJECTIVE: To investigate the therapeutic effects of different skin flaps for repairing severe complex hand injuries with burns and compression. METHODS: From January 1990 to December 2000, 39 patients with severe complex injuries due to burns and compression in the hand were treated with different skin flaps, followed by early-stage postoperative comprehensive rehabilitation therapy. RESULTS: All the patients were followed up for 6 to 12 months, and significant differences were observed in the appearance and function of the repaired hands with different skin flaps. CONCLUSION: The medial skin flap taken from the lower leg and the reverse-flow island flap from the anterior aspect of the forearm, when combined with early postoperative rehabilitation treatment, can achieve good recovery of function and appearance of the injured hand.

Adolescent↗