Biomedical subjects

Marek Trybus

Publications and source records attributed to Marek Trybus.

9 recordsLinked to original sources

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↗

PubMed2006

[Hand injuries in adolescents].

MATERIAL AND METHODS: Based on the materials of 134 adolescent patients (age 15-19) with hand injuries treated in the II Department of Surgery of the Jagiellonian University between 1987-2000 results of treatment were described. The adolescents constituted 11.8% of all patients treated due to hand injuries. RESULTS: Home was the most common place of the accident (59 patients - 44.01%), and the most common mechanism of injury was cutting by the glass or another sharp tool (61 patients - 45.52%). The mild and moderate injuries predominated (112 patients - 83.58%). 39 patients (29.10%) were treated after alcohol abuse; unfortunately. 35 patients (26.12%) were hospitalized from 1 to 24 days (av. 7.14 days). Time to obtain complete recovery reached max. 270 days but av. 55.56 days. Various degree of the persistent limitation of the hand function were observed in 65 patients (48.5%). Two of them (1.49%) got the disability pension and 8 (5.77%) had to change former job and activities. CONCLUSION: The time of the complete cure could be shorter and the extent of persistent post-traumatic impairment of the patients with the heavy hand injuries could be limited if they would be treated in the specialized centers for hand surgery.

Accidents, Home↗

PubMed2005

Alcohol-related hand injuries.

The study was based on 1199 patients consecutively treated for hand injuries in the Second Department of Surgery of the Jagiellonian University in Krakow between the years 1987 and 2000. Three hundred and twenty of these patients (26.6%) had consumed alcohol several hours before an accident. Data collected from an interview with the patient and a doctor on duty were used in the study. Routine tests for blood alcohol concentration were not carried out. Young men (89.3%), mostly manual workers (74.3%) (p<0.001), constituted the majority of patients in the alcohol group. They were younger on average (p<0.001) than sober patients. In most cases, the accident had happened at home (65.9%) (p<0.001) and the main cause of injury was a cut with glass (p<0.001). Despite only minor injuries they were treated in hospital due to their state of intoxication. The degree of hand disability was higher (p<0.05) than with sober patients. The average cost of treatment in a state of intoxication was more than twice as high as the cost of treatment in sober patients. Alcohol-related hand injuries present a major medical and socioeconomic problem.

Accidents↗

PubMed2005

[Evaluation of posttraumatic hand function in everyday activities].

The original Hand Disability Score (HDS) questionnaire which subjectively evaluates the quality of hand function in 25 one- and two-handed daily living activities was developed. The strict correlation (p < 0.001) between HDS and both severity of injury and objectively measured hand impairment was confirmed. The HDS may be used as a single estimation of hand function after treatment or as an evaluation of the progress of rehabilitation procedures.

Activities of Daily Living↗

PubMed2005

[Pelvic fractures coexistent with multiple trauma--own diagnostic and therapeutic algorithm].

Pelvic fractures determine one from greatest diagnostic and therapeutic problems in complex of multiple injures. Pelvic fractures observes one-self at 20-30% patients with multiple injures of the body. These injuries are attended for prognostic factor of severity status in this to group of patients. Using at presence diagnostic and therapeutic methods appear continually insufficient. Testifies about this high mortality in these patients. Aim of study was presentation of own manner of diagnostic and therapeutic treatment at patients with pelvic fractures coexisting with multiple injuries, and confirmation of legitimacy early reposition of pelvic fracture and external stabilisation. Investigated group of patients embraced 201 ill with multiple injuries of the body attended in years 1999-2003. Pelvic fractures were recognised at 42 (20.9%) patients. Severity of injury according to Injury Severity Score carried out 54 points. Immediate closed reposition under X-ray inspection and anterior external stabilisation executed at 12 (28.5%) most heavy patients. In this group 5 (41.6%) of the patients survived. Diagnostics and treatment one passed according to settled by authors of algorithms in which one important criterium of conduct was state stability of the circulatory system. One turned also attention on necessity wider usages of angiographic investigations of pelvic blood vessels and their immobilisation. One acknowledged that conduct according to worked out algorithms arranges and makes easy process of diagnosis and treatments. One confirmed advantages early closed reposition of pelvic fractures and their external stabilisation at unstable patients, as intervention saving life.

Algorithms↗

PubMed2004

[Hand injuries in the Krakow Region].

The material of 1199 patients with hand injuries treated in the II Department of Surgery in Krakow within the years 1987-2000 was epidemiologically elaborated. The adult population in this region counts 850,228 thousand inhabitants, therefore the number of hand injuries demanding special procedures amounts 5.74 for 10 thousand inhabitants yearly. Hand injuries most frequently affected young manual workers before 40 years of age (p < 0.001). Almost one half of accidents occurred at home (45.29%), and only 19.68% were work-related (p < 0.001). Machinery accidents (34.87%) and cutting with glass (18.43%) were two the most common causes of these injuries (p < 0.001). After the operation, prevalent number of patients (72.56%) were treated as an outpatient. The mean period of whole treatment amounts 76.95 +/- 67.81 days. It has been depended on the severity of injury and complications as well (p < 0.001). 90.59% of patients returned to previous work, and 4.89% of patients had to change their work. Disability pension was given to 4.50% of all patients.

Accidents, Home↗

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↗

PubMed2004

[Hand injuries in elderly patients].

We studied 1199 patients treated in II Department of Surgery in Cracow between 1987 and 2000. In the studied group, 138 patients were aged over 60 years. In most cases the injury took place at home (43.68%) and more often than not they occurred during operating mechanical equipment (52.89%) among which circular saw predominated (35.51%). It was revealed that the hand injuries of senior patients were more severe compared with the other patients and the permanent post-injury disability was more intense. The elderly patients with multi-tissue hand injuries should be treated in specialist centers. It is also essential to start as soon as possible the therapeutic rehabilitation (even during surgical treatment). Only such proceedings enable better final results of treatment.

Age Distribution↗

PubMed2003

[The economic impact of hand injury].

Basing on 170 cases treated at the II Surgery Department of the Medical Faculty of Kraków University, the authors have tried to assess the direct and indirect costs of treatment of hand injuries. The rates negotiated between the Małopolska NHS Provides and the University Hospital were analyzed in order to assess direct treatment costs of hand injuries. Indirect cost assessment was based on analysis of insurance costs sustained by insurance providers. The analysis showed that over 96% of total treatment costs are indirect expenses related to compensation, work absence and disability pensions. The costs could probably be extensively reduced if hand injuries were referred directly to specialized surgery units.

Adolescent↗