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At least 1,027 records · Page 57Linked to original sources
PubMed1993

Hand grenade injuries among civilians.

OBJECTIVES: To describe how noncombatants are injured by hand grenades in camps for displaced people, and to categorize grenade wounds according to the Red Cross wound classification. DESIGN: Case series. SETTING: A surgical hospital in Khao I Dang refugee camp on the Thailand-Cambodia border. PATIENTS: Seventy-four patients injured by hand grenades. INTERVENTIONS: Intravenous antibiotics and primary wound surgery. MAIN OUTCOME MEASURES: Combatant status of the patients, categorization of the wounds, surgical outcome, number of operations, and number of blood transfusions. RESULTS: Only 7% of the patients sustained their wounds in battle and 50% were women, children, or older men. Seventy had 91 wounds that could be categorized; 59% of the wounds were small, affecting only soft tissue. Few wounds were associated with fractures and none with comminuted fractures. Twenty-four soft-tissue wounds were treated conservatively with minimal morbidity and no mortality. CONCLUSIONS: Missiles (fragments or bullets) from hand grenades tend to produce wounds with little tissue damage. Serious injury is due to penetration of vital structures. The results permit a recommendation that certain small and uncomplicated fragment wounds can be treated initially without surgery.

Adolescent↗
PubMedDate not supplied

Athletic injuries of the wrist and hand. Part I: traumatic injuries of the wrist.

Hand and wrist injuries in sports are some of the most common injuries reported. This review discusses briefly the causes of hand and wrist injuries in sports and discusses pertinent biomechanical findings regarding the range of motion required in different sports activities. The bulk of the review discusses specific traumatic and overuse injuries to the hand and wrist commonly seen in the athlete. Emphasis is placed on problematic traumatic injuries such as carpal scaphoid fractures and hook of the hamate fractures, as well as ligament injuries to the wrist with regard to diagnosis, treatment, and return to athletic competition.

Athletic Injuries↗
PubMed1977

Management of compression injuries of the hand.

Management of compression injuries of the hand. Primary treatment of extreme conversatism is recommended. Repair by local tissues is superior in every way as regards function, sensation and appearance of the hand. Where local tissues cannot be used free skin grafting and distant flaps should be considered.

Adolescent↗
PubMed2002

Repair of a diaphragmatic injury during hand assisted laparoscopic nephrectomy using an onlay patch of polypropylene and polyglactin mesh.

PURPOSE: We describe a simple and time efficient technique for repairing a diaphragmatic injury occurring during right hand assisted laparoscopic radical nephrectomy. MATERIALS AND METHODS: A dual layer polypropylene and polyglactin mesh was created extracorporeally by sewing a 2 x 2 piece of polypropylene mesh to a 2 x 2 piece of polyglactin mesh with 4, 4-zero interrupted polyglactin sutures. This dual layer was then positioned manually over the diaphragmatic rent and secured with a laparoscopic stapling device. A 16Fr chest tube was placed at the conclusion of the procedure. RESULTS: Overall operative time was 3.5 hours with an estimated blood loss of 100 cc. Repair of the diaphragmatic injury extended operative time by 25 minutes. Extubation was done at the conclusion of the case and the chest tube was removed within 36 hours of the procedure. The patient was discharged home on postoperative day 3. At 14 months of followup the patient remained disease-free on radiography and without pulmonary or gastrointestinal sequelae. CONCLUSIONS: We describe a simple and time efficient technique for repairing diaphragmatic injury occurring during right hand assisted laparoscopy. This technique takes advantage of the manual and tactile sensation provided by the hand assistance device, provides a tension-free repair and avoids laparoscopic suturing.

Chest Tubes↗
PubMed1990

[Saw injury of the hand--an accident with grave sequelae].

Besides bruises saw injuries of the hand are the most common severe hand injuries. A total of 294 of 400 patients who had a saw injury between 1982 and 1986 were monitored in the course of a followup examination spanning the time of the accident up to re-entry into professional life. Causes of accidents as well as injury patterns, surgical treatment and aftereffects were analysed. The high number of injuries (70.8%) sustained while not working was remarkable as well as the fact that despite the seriousness of the injury 64.6% of the patients were content with the cosmetic results of treatment and 65% satisfied with the recovered function of the injured hand.

Accidents, Occupational↗
PubMed1989

[Pedicle ilio-inguinal axial flaps: clinical analysis of 140 cases].

Pedicle ilio-inguinal axial flaps were carried out in 140 cases with hand injury. The success rate of the operation was 97.85%. The authors consider that the high success rate was due to rare occurrence of vascular variation of the flap and more simplicity of the technique with less complications. This kind of flap could be used in cases of replacement of scar, acute injury and infective wound of hand. The donor area of ilio-inguinal flap is quite concealment. It is much better in cosmetic consideration. But still some disadvantages were existed such as fixation of the arm making discomfort to the patient, and bulky of the hand because of the subcutaneous fat in some cases.

Adolescent↗
PubMed1998

What is cold intolerance?

There are four types of symptoms on exposure to cold in the condition known as cold intolerance: pain/discomfort, stiffness, altered sensibility and colour change. They may occur in isolation or in any combination. Symptoms were present in at least 64% of 200 patients 24 months after hand injury. Pain was found to be the most troublesome symptom. Colour change in the digits was regarded by patients as the least troublesome symptom. Symptoms may begin immediately after injury, but are more likely to develop with the first onset of cold weather if there is a lag period between injury and onset. Pre-existing cold related symptoms are uniformly made worse by hand injury. A definition of the condition has been proposed and it has been suggested that this collection of symptoms be known as "Trauma Induced Cold Associated Symptoms".

Adult↗
PubMed2004

Acute hand and wrist injuries in experienced rock climbers.

BACKGROUND: The sport of rock climbing has its own spectrum of injuries, almost half of which involve the wrist and hand. OBJECTIVE: To examine the incidence of acute wrist and hand injuries in 545 members of The Climbers' Club of Great Britain. METHOD: A total of 1100 questionnaires were sent to current members of The Climbers' Club of Great Britain for them to detail any hand and wrist injuries sustained to date. In decade years, the climbing grades and time spent climbing at each grade were determined. From these results a total and historic climbing intensity score for each climber could be calculated. RESULTS: Half of the questionnaires were returned complete. The respondents were almost entirely male. There were 235 wrist and hand injuries in 155 climbers (28%). The climbing intensity scores were significantly higher in the injury group than in those who had not suffered a wrist or hand injury (p<0.05). Finger tendon injuries were the most common injury, followed by abrasions/lacerations and fractures. DISCUSSION: The most common injuries found in rock climbing involve the wrist and hand. The predominant injury to the hand involves the finger tendons or pulleys. The greater the climbing intensity calculated over a climber's career, the greater the likelihood of sustaining these injuries.

Acute Disease↗
PubMed2004

Providing care for hand disorders a re-appraisal of need.

An audit of hand surgery activity in Derby during the period 1989-1990 produced manpower and resource recommendations for the speciality per 100,000 of population per year for the United Kingdom. The decade that followed the audit has seen major changes in health care provision, including reduced service activity by trainee doctors through restricted hours of work and less unsupervised surgery. A further audit of hand surgery activity was performed during 2000-2001 to assess the effects of these and other changes. This showed that there has been a 2% rise in trauma attendances, though trauma bed utilization had reduced by 12% and surgery time by 38%. Trauma out-patient visits had also reduced by 11%. Day-case trauma surgery rates were virtually unchanged at 63%. Women attend more frequently with traumatic hand injuries than they did 10 years ago and there is a rising incidence of hand injuries in the home, with a falling incidence at work. Elective referrals have risen by 36% and operations by 34%. The top ten diagnoses relate to the same conditions although their rankings have changed. Elective day-case surgery rates have risen from 64% to 94% over the decade. The 34% increase in elective operations has been absorbed within a 5% reduction in elective bed use and a 23% reduction in surgery time. Elective out-patient visits have also dropped 14% overall. This audit indicates that in 2000-2001 one whole time equivalent hand surgeon can service a population of 125,000. The national requirement for a 56 million population would be 448 whole time equivalent hand surgeons.

Adolescent↗
PubMed1983

Hoffmann pelvic stabilization for injuries to the hand and wrist.

We have used the pelvic Hoffmann technique successfully on two patients requiring flap coverage and have had no difficulty with its management nor complications with the pelvic pin fixation. We feel that this type of fixation provides significant advantages for the treatment of hand and forearm injuries requiring flap coverage for avulsing injuries to the hand and wrist.

Adult↗
PubMed1993

[Amputation of fingers or a hand. Accident or self-mutilation].

Among the high number of cases of hand injuries investigated each year by accident insurance companies, cases continually occur which give rise to the suspicion of attempted insurance fraud by means of purposely inflicted injuries. Such cases are often difficult to prove. Based on 3 case reports (amputation by means of a chain saw, a blow with an axe and a cutting machine), reconstruction at the place of the crime is shown to be extremely advantageous. The reconstruction of the crime is one of the most important evidential elements. It is recommended for all cases where there is any doubt.

Adult↗
PubMed1996

The pattern of tissue damage in occupational trauma.

OBJECTIVE: To study the pattern of tissue damage in occupational hand injuries. SETTING: Trauma and Orthopaedic Unit of the General Hospital, Colombo. PATIENTS: 190 patients with occupational hand injuries submitted to surgery by me were studied prospectively. The incidence of compound and simple fractures and dislocations, digital amputations, tendon injuries and skin loss were studied. The individual bones and tendons affected, the level of digital amputations and the involvement of individual fingers were recorded. RESULTS: Compound fractures accounted for 42.1% of injuries and in 56.4% the distal phalanx was involved. Finger tendons were affected in 66.6%. The highest incidence of compound fractures (30.6%), amputations (41.1%) and skin and subcutaneous tissue loss (28.5%) was seen in the index finger. CONCLUSIONS: 1. Compound fractures and digital amputations were the main injuries. 2. Distal phalanx is more frequently affected in compound fractures. 3. Among the amputations loss of finger tip is the commonest. 4. Flexor tendons were more injured than the extensor tendons. 5. Index finger is the most frequently injured digit.

Accidents, Occupational↗
PubMed2003

[Medical responsibility in hand traumatology].

The apparently benign nature of many hand injuries may lead one to underestimate the potentially serious consequences of these injuries. In case of significant residuals, patients may consider themselves victims of inadequate treatment. The traumatic lesions may be classified into three groups of increasing severity (mild, moderate and severe emergencies) which require the services of increasingly sophisticated treatment teams: Services d'Accueil des Urgences (SAU) (general emergency care facilities) for minor injuries, general surgery emergency services for more severe injuries, and specialized teams such as the centers of the "Fédération Européenne des Services Urgences Mains" (FESUM) for serious complicated injuries. This differentiation is correlated to the level of expertise of the treatment team and the quality of the technical support at their disposition. Proper match of the severity of injury with the level of expertise of the treatment team can minimize the incidence of poor results and resultant litigation. Personalized treatment given with the informed consent of the patient, and his understanding that all necessary resources will be utilized, will lessen the tendency for the patient to consider some less than perfect results as the consequence of inadequate care, and therefore, lessen the likelihood of litigation against the physician or hospital. The evaluation of the permanent impairment should be analyzed as the difference between the actual result and similar, if not strictly identical cases given the appropriate level of treatment. In order to limit the frequency of litigation, including unjustified lawsuits, it is necessary, as a preventive measure, to integrate these precautions into the plan for provision of care for hand injuries.

Hand Injuries↗
PubMed1986

Ligamentous injuries of the hand in athletes.

Injuries to the small joints of the hand are prevalent in both professional and amateur athletes. The majority of these injuries result in partial tears of the capsular support structures and can be successfully treated by precise splinting followed by thorough rehabilitation. In contrast, optimal management of complex dislocations or complete ligament ruptures causing serious joint instability necessitates operative intervention to secure reduction and facilitate ligament healing. There is an enviable satisfaction in observing a recovered athlete perform to the limits of his or her abilities, unimpaired by any residual disability or deformity. This goal can only be achieved by the timely institution of skillful management.

Athletic Injuries↗
PubMed2003

Pediatric hand treadmill injuries.

The great popularity of physical fitness in modern society has brought many pieces of exercise equipment into our homes for convenience and privacy. This trend has come with an increasing rate of injuries to children who curiously touch moving parts, including treadmill belts. Experience with a recent series of treadmill contact burns to children's hands is described in this article. A retrospective chart review at a tertiary referral center from June 1998 until June 2001 found six children sustaining hand burns from treadmills. The patients' ages at presentation ranged from 15 to 45 months (average of 31 months, three boys and three girls). All injuries occurred in the home while a parent was using the treadmill. Burns involved the palmar aspect of the hand, mostly confined to the fingers, and the severity ranged from partialto full-thickness burns. All patients were initially managed with collagenase and bacitracin zinc/polymyxin B powder dressings to second- and third-degree burns, along with splinting and range-of-motion exercises. Two patients required skin grafting at 2 weeks and 2 months for full-thickness tissue loss and tight joint contracture, respectively. At an average follow-up of 12 months, all patients had full range of motion and no physical limitation. The rate of children injured by exercise equipment is expected to increase. Friction burns to the hands remain a concern, although early recognition and appropriate management are associated with excellent functional outcomes. Protective modification of exercise machines seems to be the best approach to eliminating these injuries.

Accidents, Home↗