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At least 19 recordsLinked to original sources
PubMed1993

Rehabilitation following traumatic hand injury: hand therapists' perspective. Part 1: Acute phase of hand rehabilitation.

The specialty of hand therapy was developed in response to advances in surgical techniques that enabled greater functional restoration of injured and diseased upper extremities. Such restoration requires the therapeutic intervention of a skilled, specialized practitioner who is able to integrate the principles of rehabilitation with these surgical interventions (Chai, Dimick, & Dasach, 1987). This article will provide a general overview of hand therapy as practiced by one midwestern institution.

Bandages↗
PubMed2004

Assessment of the severity of hand injuries using "hand injury severity score", and its correlation with the functional outcome.

INTRODUCTION: Objective assessment of hand injuries is a complex subject. However, an objective assessment, leading to a score, can help in predicting outcome and can be used as a research tool. Campbell and Kay have devised one such score known as "hand injury severity score" or HISS [J. Hand. Surg. [Br.] 21 (3) (1996) 295]. A study on this score has been carried out in our institute. The idea was to see if the hand injury severity score, correlates with the functional outcome as measured by disability arm shoulder and hand score (DASH), after a period of minimum 2 years. METHOD: All the hand injury patients admitted in the hospital were assessed at the time of admission, and objective information was documented on a hand injury documentation form. The form captured all the data required to calculate "hand injury severity score" . A sample of 70 patients admitted during the first 6 months of 1999 was taken and their scores were calculated. The sample was selected such, that it had a reasonable representation of hand injuries of all severities. After obtaining a due approval from ethics committee, all these 70 patients were sent a DASH questionnaire. A total of 23 patients replied. Spearman's rank correlation test was used to analyse the correlation between the severity of hand injury as assessed using HISS, and functional outcome as measured using DASH. Correlations between the outcome and skeletal component score, outcome and motor component scores, and outcome and Integument component scores, were assessed separately. RESULTS: The study shows a statistically significant association ( r = 0.7182, P = 0.000165) between the severities of injury and the functional outcome. The functional outcome also shows a statistically significant association with the severity of injury to skeletal component (r = 0.5151, P = 0.014083) and motor component (r = 0.6797, P = 0.000507). However, the severity of injury to integument component, as measured by HISS, does not show any association with the outcome (r = 0.3571, P = 0.102736). This study supports the overall structure of the HISS. However an improvement in the integument component scoring is required to improve overall accuracy.

Accidents, Occupational↗
PubMed2002

Athletic hand injuries.

Hand injuries are among the most common injuries arising from athletic participation. Suboptimal outcomes from poorly treated athletic hand injuries can produce functionally disabling injuries. Careful assessment and, when needed, radiographic studies are critical for the accurate and complete diagnoses of hand injuries. Carefully thought out modifications may accelerate the time for return to competition. A thorough understanding of these many variables can enable the physician to minimize time lost without compromising care.

Athletic Injuries↗
PubMedDate not supplied

The Injured Workers Survey: development and clinical use of a psychosocial screening tool for patients with hand injuries.

Hand therapists often recognize that their patients are experiencing psychosocial distress following traumatic hand injury but may lack the time and training to determine whether referral for psychological assessment and treatment is warranted. The Injured Workers Survey (IWS) is a brief, effective self-report tool that screens for psychosocial distress, in particular for characteristic symptoms of post-traumatic stress disorder (PTSD). It also collects clinically relevant information about other psychosocial issues that have a major effect on treatment outcomes. A recent research study has validated the IWS as a screen for PTSD and supports its routine use in the initial assessment of all patients with traumatic hand injuries. To the extent that psychosocial distress interferes with recovery, its early identification and treatment can optimize overall treatment outcomes and facilitate successful in return to work.

Hand Injuries↗
PubMed1985

Anesthesia for hand injuries.

Hand injuries account for an increasing incidence of emergency room visits, both for purposes of diagnosis and treatment. Patients are also expressing a growing reluctance toward hospitalization for procedures that are now performed with precision in the office or same day surgical unit. These two factors are largely responsible for an increasing reliance on regional techniques to provide optimal anesthesia. The safety, versatility, ease of administration, and consistent success of regional anesthesia validate its frequent use.

Anesthesia, Local↗
PubMed2003

Hand therapy management following mutilating hand injuries.

Hand therapy can optimize functional outcomes following various surgical procedures of the hand. Rehabilitation is especially essential following mutilating injuries in which multiple systems are involved. The healing process and therapeutic techniques foreach system are discussed in this article. Treatment guidelines for flaps, replantation, and toe to digit transfers are also included.

Biomechanical Phenomena↗
PubMed2004

[The prognostic value of the Hand Injury Severity Score in industrial hand injuries].

BACKGROUND: We evaluated the value of the "Hand Injury Severity Score" (HISS) in determining the prognosis of industrial hand injuries. METHODS: Hand injury severity scores of 112 patients (17 females, 95 males; mean age 31 years; range 15 to 54 years) were calculated following surgery for industrial hand injuries. During the course of rehabilitation program, the patients were followed-up regularly. Pearson correlation coefficients were used to determine the relationship between the HISS scores and the time intervals from injury to healing and return to work. RESULTS: The mean HISS score was 37.1+/-27 (range 6 to 116). The time to healing ranged from 12 to 210 days (mean 73.7+/-40.7 days). All the patients returned to work after a mean of 80.4+/-52.9 days (range 7 to 300 days), mainly to previous working places with (12%) or without (79%) changing job activities. Nine per cent of the workers had to change their jobs. The HISS scores were found to be correlated with the healing period and the time to work (p<0.05 and p<0.000, respectively). CONCLUSION: The results of this study indicated that HISS was a useful system in predicting the prognosis in the early stages of industrial hand injuries.

Accidents, Occupational↗
PubMed2006

Causes and consequences of hand injuries.

BACKGROUND: Hand injuries are considered to be the most frequent body injuries, the treatment of which is of long duration and great community expense. The aim of this study was to define the most frequent causes of hand injury in the investigated materials; the severity of hand injuries and outcome of treatment performed in the typical trauma surgery ward; and overall costs of hand-injury treatment. METHODS: Between 1987 and 2000, 1199 patients (average age 37.0 years (+/- 15) were treated for complex hand injuries in II Surgery Clinic in Cracow. Causes, places, and mechanisms of hand injuries were evaluated as were types and duration of treatment. We also estimated also total (direct and indirect) treatment costs. RESULTS: Of all hand injuries, 45.3% occurred at home and 19.7% at work. Hand injuries caused by mechanical equipment predominated (34.9%) and were the most severe. Up to 26.7% of injuries occurred after alcohol consumption. Average total treatment time was 76.9 days (+/- 67). Hand impairment of variable severity was found in 58.5% of patients. Indirect costs constituted a dominant part of overall costs (96%). CONCLUSIONS: The complex treatment of the injured hand at specialist centers allows for shorter treatment duration, improved treatment results, and decreased indirect expenses.

Accidents, Occupational↗
PubMed2004

[Occupational hand injuries].

BACKGROUND: Hand injuries are the most frequent bodily traumas sustained at work. The aim of the study was to assess hand injuries and the results of their treatment in a group of our patients. MATERIALS AND METHODS: The study covered 275 patients with occupational hand injuries treated in the II Department of Surgery, Collegium Medicum, Jagiellonian University, Kraków, during the years 1987-2000. The injury severity was estimated according to our own injury severity scale and the degree of hand disability according to the norms for certifying permanent posttraumatic disability issued by the Ministry of Health. The control group comprised 924 patients with non-occupational hand injuries treated in our Department in the same period. RESULTS: The study revealed that occupational hand injuries were more severe than those sustained in other conditions, their treatment was longer and posttraumatic disability more severe. CONCLUSIONS: More severe occupation-related injuries should be treated in hand surgery specialized centers.

Accidents, Occupational↗
PubMed1989

Microsurgical reconstruction of opposable digits in mutilating hand injuries.

Multilating hand injuries with multiple digital amputations require a cooperative patient, a highly skilled hand/microsurgical team, and a continuum of hand rehabilitation therapy for optimal functional salvage. A systematic approach for assessing a patient's functional deficit and reconstructive requirements contributes to a coordinated reconstruction and rehabilitation plan designed to optimize functional gains. Today's sophisticated microsurgical reconstruction coupled with comprehensive hand therapy generally represents the best option for patients with mutilating hand injuries. Throughout reconstruction and rehabilitation the ultimate goal of multilating hand injury care, that of restoring a functional extremity that is useful in a patient's daily life must be remembered.

Amputation, Traumatic↗
PubMed2000

[Study on early repair of destructive hand injury and reconstruction of hand function].

OBJECTIVE: To investigate a clinical method in repairing destructive hand injury and reconstructing hand function in early stage. METHODS: From January 1990 to June 1999, composite tissue transplantation was used to repair destructive hand damage and reconstruct hand function with vascular anastomosis in emergency (33 cases) or subemergency (126 cases). For the radial damage, combined flaps with toes was used to treat cicatricial contracture of thumb-web space. Opposing function of thumb was reconstructed by combined transplantation of short extensor muscle of great toe, short extensor muscle of toes or short abductor muscle of great toe in the same time of freeing the second toe. For no or deficient anastomosing vessels in donor site, "Y"--shaped reversal vein, anterograde bridging, or branches bridging of host vessels were applied. RESULTS: All of tissue transplantation were survived, including combined tissue transplantation in 51 cases, composite tissue transplantation in 4 cases, tissue transplantation after replantation of severed wrist and finger in 4 cases, there were no infection or necrosis in all cases, and hand function recovered well. CONCLUSION: It is an ideal procedure to repair destructive hand injury and reconstruct hand function by combined or composite tissue transplantation with vascular anastomosis in emergency or subemergency.

Adolescent↗
PubMed2003

Secondary procedures following mutilating hand injuries.

Mutilating hand injuries result in injury to multiple anatomic structures, which increases the possibility that secondary procedures or staged reconstruction will be necessary. Secondary procedures often are required to provide stable wound coverage, restore sensation, provide bony stability, increase range of motion, or allow prehension, all of which are performed to improve hand function. The patient, the surgeon, and the therapist must all work together to achieve the best functional result following a severe mutilating hand injury.

Contracture↗
PubMed1984

Acute management of severe hand injuries.

Mutilating hand injuries are extraordinarily complex, involving all structures of the hand. Immediate treatment priorities are described, and planning for staged reconstruction is formulated, based on the most reasonable and realistic goals involved in restoration of use for the patient.

Amputation, Surgical↗
PubMed2003

Pediatric mutilating hand injuries.

Mutilating hand injuries in children are a devastating problem. With aggressive efforts at replantation and revascularization, methodic debridement, timely soft tissue coverage, and early mobilization, however, the results in these unfortunate children can be quite rewarding. The child often does well with the functional aspect of recovery and rehabilitation but will probably hide his or her deformed hand from friends and family. These children generally become more shy and reserved. The parents are the key to rehabilitation. A good relationship between the parent, the physician, and the hand therapist is essential for the best result. Interestingly, the parents who are the most demanding on the staff during the initial emergency period are often the most appreciative parents and their children often achieve the best result. Conscientious parents are the best advocates for their children. Obviously, the prevention of these devastating injuries is much preferable to extraordinary heroic reconstruction. Unfortunately, some injuries are inevitable. It is nearly impossible to create an absolutely hazard-free environment for children. Potential injuries can be avoided, however, simply by keeping hazardous machines and equipment out of the reach of the child and by keeping children out of the potentially dangerous workplace.

Amputation, Traumatic↗