["Cut injuries" of the hand-- a challenge to the present status of continuing education in surgery].
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The diagnosis of peripheral nerve lesions remains difficult despite the sophisticated technology which is currently available. Experience with the Doppler, photoelectrical plethysmography and flow studies is analysed. Recording of antidromic sensory action potentials in dependence on acral thermometry as the only objective diagnostic procedure proved correct when compared with the indirect procedures via arterial vascular system, namely Doppler, photoelectrical plethysmography and flow studies. The application of the above techniques in a case report with sphygmographic assessment is described.
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Animal bites as well as human bites of the hand have an outstanding position in traumatology care because of their high rate of complications compared with bite wounds at other localisations. The authors report about the results of 128 patients with animal or human bite wounds of the hand treated at the University Hospital for Traumatology in Vienna from 1988 to 1992.
For many years, the rule "Emergency Treatment, Deferred Surgery", advocated by Marc Iselin, led to saving severely injured hands by postponing surgery and leaving it to highly specialised surgeons. With the appearance of microsurgery, which can be used for arterial and venous repair, the notion of actual emergency has returned and has led to the philosophy of "One-Stage Repair with Early Mobilisation". This consists in emergency repair of all the lesions and selection of techniques compatible with active mobilisation in the first postsurgical days. It is thus possible to avoid the major complication represented by stiffness of the hand in the fundamental role of grasping which requires mobility and sensitivity. Thus, Units for Emergency Hand Treatment must be created. In 1972 Raymond Vilain had the foresight to open the first such unit, "SOS MAIN". In 1975 a unit was opened in Strasbourg and five years later the European Federation of Units for Emergency Hand Treatment was born; today it comprises approximately 40 units within Europe.
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Bowling is one of the oldest and most popular indoor sports. The earliest evidence of bowling dates back to ancient Egypt. Archaeologists discovered equipment for a game resembling bowling. Modern forms of bowling appeared in England as early as the 1100s. Bowling can cause a variety of hand and upper extremity injuries either due to acute or reparative forces. Greater number of such injuries is being encountered as the popularity of the game has increased. The goal of this article is to present an overview of bowling related injuries, their mechanisms along with preventive and treatment measures.
This prospective trial collected all cases where injuries had resulted from the hand passing through or striking glass and had been referred to a hand injury service during 1 year. Eighty-seven cases were referred and the factors relating to these injuries were examined. A record was made of the structures damaged, the surgery performed and prevailing socioeconomic factors. These injuries were very costly in terms of morbidity, surgical effort and time, with significant resource implications. The study appears to confirm other reports that current legislation on glazing safety was too long delayed and is inadequate now that it is in place.
We report a shotgun injury of the hand, in which two new procedures for plastic surgical repair were carried out. These procedures may be applicable elsewhere in plastic surgery.
Pay phone receiver cord injuries to the hand have been identified in five hands of three patients. These injuries occur when the individual tries to violently jerk the receiver from the main unit of the telephone by the metal sheathed cord. This flexible metal sheath then becomes uncoiled and exposes very sharp edges on which hands can be severely lacerated and mutilated. Identification of and experiences with these types of injuries are discussed.
This study reports the causes, characteristics and treatment of injuries to the hand and wrist presented to five accident and emergency departments in a 2-year survey of 13% of the Danish population. The rate of injury to the hand or wrist was 28.6% of all injuries, or 3.7 per 100,000 inhabitants per year. 34% of the accidents were domestic, 35% were leisure accidents, 26% were occupational and 5% were traffic accidents. Only 2% of the patients were admitted to hospital for further treatment or observation and 13% were referred to a hospital as outpatients. The most frequent causes for admission were fractures (42%), tendon lesions (29%) and wounds (12%).