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PubMed1989

[Complex evaluation of hand function].

The authors offer a method of assessment of hand function which renders numerical data, in which all functions of the hand are represented with appropriate emphasis. The result of the examination is expressed as a percentage of perfect function. The method, which seems on first reading somewhat complicated, can be simplified very much with a computer aided work-up of data. The method is suggested first of all for the assessment of the results of healing in severe complex hand injuries. It is also suitable for the expression of hand function in all cases (for example, judgement of the decrease of working capacity and decisions on insurance claims, etc.).

Amputation, Traumatic↗
PubMed1976

Pressure gun injection injuries of the hand.

Pressure gun injection injuries are becoming increasingly common. Their effect on the fingers and hands, especially when improperly managed, can be devastating. Therefore it is important to review features, clinical course, anatomic distribution and operative management of such injuries. If a useful hand and fingers are to be attained, rapid and thorough decompression and debridement of these injuries are essential.

Accidents, Occupational↗
PubMed1994

Anesthesia in the emergency setting: Part I. Hand and foot injuries.

Topical application and local infiltration of anesthetic agents are useful for localized areas, while a circular field block provides superficial anesthesia within the encircled area. Regional anesthesia is accomplished by injecting the anesthetic agent near a nerve or nerve group. Useful anesthetic techniques for repair of hand injuries include wrist blocks, intermetacarpal blocks and local infiltration anesthesia. Median nerve block, ulnar nerve block, radial nerve block or a combination of these blocks provides satisfactory anesthesia without inducing muscle paralysis in the anesthetized region. Intermetacarpal digital blocks are used to anesthetize any finger. Local infiltration is useful for closing minor lacerations. For foot injuries, the posterior ankle block is used to anesthetize the sole. The anterior ankle block is used for the dorsum of the foot.

Anesthesia, Local↗
PubMed1978

The roll-bar hand.

This report describes a new hand injury seen in passengers in dune buggies having rollover accidents. Since these vehicles are usually driven off the road and far from treatment centers the treatment of these injuries is often delayed. As the rollover takes place, the reflex action--usually of the passenger--is to grasp the roll bar. A crush-avulsion injury occurs at the level of the metacarpals, with the thumb frequently spared. Wound contamination, delay in treatment, and the frequency of other serious injuries add to the seriousness of this injury. Redesign of the roll bar, provision of better passenger protection, and an internal grasp support are suggested to reduce its incidence.

Accidents↗
PubMed1976

Office and emergency room care of the injured hand.

A careful initial evaluation and proper treatment of the injured hand can minimize morbidity and assure early recovery. Various hand injuries encountered and their appropriate treatment are discussed. Emphasis is placed on the initial care, and in some instances the definitive treatment, which can be given in the physician's office or the hospital emergency room.

Amputation, Traumatic↗
PubMed2004

Upper limb flaps for hand reconstruction.

This article reviews three of the most popular upper limb flaps used in hand surgery, namely the posterior interosseous flap, the lateral arm flap and the radial forearm flap. An anatomic study performed with the use of eight fresh cadavers (sixteen upper limbs) is supported by a wide review of the literature. The combined posterior interosseous and lateral arm flap is also discussed. It is concluded that these flaps are easily harvested and dependable and in spite of any disadvantages their combination should be adequate for the treatment of almost any hand injury.

Adult↗
PubMed1990

Epidemiology of hand and wrist injuries in sports.

Most sports are associated with specific patterns of hand injury. In some cases, these are unavoidable due to the nature of hand involvement dictated by the rules or environment of the sport. In other cases, such injuries point out the need for better protective gear or training.

Athletic Injuries↗
PubMed2005

Toe-to-hand transfer from a cross-foot replantation in a traumatic four-extremity amputation.

Treatment of mutilating hand injuries often requires multiple innovative procedures. This report describes a case of multi-limbed amputations from a train injury and the extraordinary microsurgical approaches for a two-hand reconstruction. The first stage of the procedure was a cross replantation of the left foot to the right leg. The second stage was a combined second and third toe transfer from the cross replantation of the left foot to the right hand, and a sensate fibular osteocutaneous flap transfer for left hand reconstruction. Satisfactory function was restored, including good protective sensation. These kinds of extraordinary microsurgical approaches are useful salvage procedures for hand reconstruction, when presented with a case of multi-limb amputation.

Adolescent↗
PubMed1997

Combined thermal and crush injury to the hand and fingers.

Combined thermal and crush injury is a relatively rare type of injury, although it may be more common in industrial settings. The combined insult of heat and pressure results in an injury that apparently is more severe than the simple additive effect, as the heat is transmitted deeper through the crushed tissues. The full extent of tissue destruction cannot always be fully recognized initially. Treatment in stages is the preferred approach, rather than attempted immediate reconstruction procedures. Failure of immediate skin grafting procedures in some of the cases presented herein was the result of underestimation of the severity of trauma. Early debridement should be done soon after admission. Definitive treatment as dictated by the magnitude of injury needs to be delayed until the extent of injury is delineated. Our conclusions from the presented experience with this type of injury were successfully applied in the treatment of the last presented patient.

Accidents, Occupational↗
PubMed1989

Detection of submaximal effort by use of the rapid exchange grip.

To assist in distinguishing patients with truly decreased hand grip strength from those deliberately not gripping the dynamometer at maximal capacity, a rapid exchange grip strength test was devised and tested under four conditions. Part I, 100 normal subjects undergoing static grip testing and the rapid exchange grip test. Part II, 45 patients chosen at random from physical therapy with various hand injuries tested using only the static grip test. Part III, a blind control study on 15 normal subjects instructed to fake an injury to either the right or left hand. This group was given both the static and rapid exchange grip test. Part IV, a retrospective evaluation of 45 patients seen in a private hand practice who had both the static and rapid exchange grip test. After the dynamometer had been set to the position at which the patient had previously achieved maximal grip strength, the patient was instructed to rapidly alternate hands while gripping the dynamometer. Uninjured subjects had consistently lower rapid exchange grip test scores than previous scores at the same setting (negative rapid exchange grip). Average rapid exchange grip test scores were higher than previous scores (positive rapid exchange grip) when subjects were instructed to fake an injury with one hand. We conclude that if maximal performance has not been achieved on the static test, the rapid exchange grip shows a significant increase in grip strength on the affected side. More patients claiming worker's compensation had positive rapid exchange grips and the average score was higher than that of patients not claiming worker's compensation.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1993

Common hand and wrist injuries in basketball players.

Multiple injuries to the hand are relatively common in basketball. This article explains the importance of an early and thorough examination, preferably by a hand specialist. It is important to obtain a history of prior injury during the assessment because treatment and prognosis may be very different. Delayed treatment often yields an inferior result and lost time. If an injury is not treated initially, it may require operative treatment or even be untreatable.

Basketball↗
PubMed1977

Injuries to the hand and wrist in athletes.

Injuries involving tendons, ligaments, and bones are commonplace with many physical activities. Although the majority of these injuries are minor and cause only temporary discomfort, their potential for producing serious and occasionally permanent disabilities must not be ignored. The initial physical and roentgenographic examination of the injured part must be thorough. Only then can the severity of the injury be recognized and appropriate treatment undertaken. Promptness will limit the period of disability and minimize the chances of development of a chronic condition.

Athletic Injuries↗
PubMed1990

Ice-skating injuries to the hand.

166 patients with injuries due to ice-skating were seen in the local accident and emergency department over a six-month period; 60% of these involved the upper limb. 28 of the upper limb injuries were closed fractures and 24 were lacerations, almost all to the dorsum of the hand. The use of protective gloves would help to prevent these potentially avoidable injuries. "On-site" first-aid facilities help to reduce the demand on the local accident service.

Adult↗
PubMed1959

Crushing injury of the hand; prevention of ischemic contracture.

Crushing injury of the hand usually causes "explosive" damage. Subsequent swelling of the palmar structures further impairs venous outflow, and hemorrhage into structural spaces increases the pressure. The arterial system and the large dorsal veins, however, are seldom obstructed and provide adequate circulation unless hampered by improper bandaging. A bandage that compresses the dorsal veins causes back-pressure, which increases the swelling further and brings about ischemia. Swelling and pain cause the patient to restrict exercise of the injured hand, which permits contractures to develop. The author has averted this sequence in more than 100 cases by preserving integrity of veins during debridement, arresting hemorrhage, bandaging the hand with compression dressings in functional flexion, and reducing swelling with hyaluronidase. In these cases, on removal of bandages in 24 hours, swelling was reduced and continued to diminish. All patients exercised the hand at this time without discomfort and only a few required aspirin for pain.

Bandages↗