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At least 973 records · Page 54Linked to original sources
PubMed2005

Pediatric hand trauma.

Hand injuries in infants are an exciting challenge for those who treat pediatric trauma patients. We will review different hand injuries and provide basic rules for their treatment and followup. We will compare our experience with published results. When compared with adults, two main differences arise in treatment of pediatric hand injuries: children have an exceptional regenerative ability that allows procedures to be used that would not be useful in older patients (eg, replantation after avulsion injuries) and children have a high degree of cooperation with physicians. The main goal of treatment should be to have children return quickly to their daily leisure and academic activities.

Adolescent↗
PubMed1987

Dupuytren's contracture, alcohol consumption, and chronic liver disease.

This prospective study was undertaken to assess the prevalence of Dupuytren's contracture (DC) and its relationship with possible causes, especially alcohol consumption and chronic liver disease. Four hundred thirty-two consecutively hospitalized patients were examined for evidence of DC. They were divided into five groups based on the following clinical, biologic, and histologic criteria: alcoholic cirrhosis (89 patients), noncirrhotic alcoholic liver disease (55 patients), chronic alcoholism without liver disease (46 patients), nonalcoholic chronic liver disease (68 patients), and a control group (174 patients). The prevalence of DC in these five groups of patients was 32.5%, 22%, 28%, 6%, and 12%, respectively; the prevalence of DC was higher in patients with cirrhotic or noncirrhotic alcoholic liver disease (25.5%) than it was in patients with nonalcoholic liver disease (6%), but it was not significantly different in alcoholic patients with or without liver disease. The relationship between DC and age, sex, manual labor, previous hand injuries, diabetes mellitus, alcohol consumption, and cigarette smoking was assessed by univariate and logistic regression methods. Nine variables were significantly different in patients with or without DC: age, sex, manual labor, previous hand injuries, diabetes mellitus, daily alcohol consumption, duration of alcohol consumption, total alcohol consumption, and duration of cigarette smoking. In our patients, variables that could explain DC were, in decreasing order, age, total alcohol consumption, sex (male), and previous hand injuries. In alcoholic patients, these variables were age and previous hand injuries; in nonalcoholic patients, these variables were age and cigarette smoking. These results emphasize the high prevalence of DC in alcoholic patients and the absence of a correlation between DC and chronic liver disease. Age and alcohol consumption are the best explanatory variables of DC in hospitalized patients.

Adolescent↗
PubMed2000

Amputation of the middle ray in the primary treatment of severe injuries of the central hand.

Severe injury to the middle finger often compromises both the appearance and function of the hand. This report discusses the use of total middle ray amputation at the time of primary trauma surgery to avoid predictable problems that arise when the ray, or part of it, is retained. Primary ray amputation eliminates the defective middle finger, avoids a gap hand, and reunites the dissociated radial and ulnar segments of the hand to create a useful, three-fingered hand.

Amputation, Traumatic↗
PubMed1990

Pathophysiology of overuse injuries in the hand and wrist.

Injury from overuse is an important and increasingly common problem in athletes and health-conscious people. The unaccustomed application of repetitive stress to any tissue may cause sufficient structural disruption to overcome that tissue's adaptive ability and thus cause injury without necessarily causing complete loss of function. The events leading to injury, as well as the level of stress required to incite them, may vary depending on the tissue and the individual. The pathway common to all tissues most likely involves microdamage to tissue collagen, combined with a direct or indirect effect on the microvasculature, with subsequent oxygen deprivation. The inflammation and repair process common to all tissues is well described. An understanding of this process is critical in the optimal treatment of these injuries. The modification of factors, both intrinsic and extrinsic, is important in the prevention of injury and in a rehabilitation program aimed at return to sports.

Athletic Injuries↗
PubMed2006

[Blast injuries of the hands. Patterns of trauma and plastic surgical treatment].

BACKGROUND: Blast injuries of the hand represent a demanding surgical emergency for the reconstructive hand surgeon. Commercially available fireworks are often regarded as less dangerous compared to combat ammunition, but the following examples demonstrate their real potential for devastating hand injuries. Some of the closed injuries can represent a pitfall for correct assessment of trauma severity. PATIENTS AND METHODS: Fifty patients who were seen after fireworks explosions from December 1995 until April 2005 were analyzed in respect to their patterns of injury and their subsequent surgical treatment. The severity was graded using the Hand Injury Severity Score (HISS). The majority of patients were injured during the New Year's day celebrations and presented with complex blast injuries due to commercially available, CE-certified fireworks. RESULTS: Depending on the size of the explosives comparable patterns of injury were seen. Larger shells led to traumatic subtotal amputations of the exposed fifth finger ray and thenar ray. Complex destructions with multiple fractures and avulsions of the midhand were also present. Smaller explosives caused multiple lacerations in the palm of the hand, subcutaneous flexor tendon ruptures, and closed fingertip fractures. DISCUSSION: Acute neurapraxias and neural compartment syndromes were clinically present. All patients (50) had to be operated primarily, and subsequent operations were necessary in 19 cases (number of operations 1-4, med. 1). In the HISS grading, 18 "minor" (HISS <20), 16 "moderate" (HISS 21-50), 7 "severe" (HISS 51-100), and 9 "major" (HISS >100) explosion injuries were present (range: 2-155, med. 47). CONCLUSION: Blast injuries of the hand need a fast, strategically planned surgical approach. This is also true for presumably harmless, CE-certified fireworks. In a multiple patient scenario, triage based on surgical urgency may be necessary. A detailed clinical examination and surgical exploration is mandatory to avoid possible pitfalls like in closed injuries. Profound skills in reconstructive and microvascular hand surgery are essential to achieve an optimal clinical outcome.

Adolescent↗
PubMed1997

Nail gun injuries of the hand.

Nail gun injury of the hand is commonly encountered among workers in the construction industry. Successful management requires a thorough understanding of this unique injury, the recognition of nail shaft barbs, and appropriate nail removal and wound care, with referral when indicated. If barbs are encountered, nail removal involves cutting off the head of the nail and extracting the nail in the direction of entry.

Adult↗
PubMed1991

[Surgical treatment of radiation injuries of the hand].

An analysis is given to pilot experience with up-dated plastic surgery techniques in management of hand radiation injuries. Seven patients underwent surgery involving cross-over skin, scapular, radial and inguinal grafts, sliding Littler island graft. The results (both short- and lond-term) turned promising.

Dermatologic Surgical Procedures↗
PubMed1977

Dorsal silicone rods in the primary care of war injuries.

During armed combat serious hand injuries are often neglected only to receive the attention they deserve far too late. The authors have employed a vigorous approach to the primary care of severe war injuries to dorsum of the hand introducing silicone rods where extensor tendons have been destroyed and where skin closure is obtained using inguinal skin flaps.

Hand Injuries↗
PubMed1993

Application of hand dressings.

The hand dressing is a vital part of postoperative care and treatment of hand injuries. Changing a hand dressing can be a frustrating and traumatic experience for the patient and the person changing the dressing. By applying the basic principles and following the steps found in this article, changing a hand dressing becomes a simple procedure that facilitates healing.

Adult↗