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PubMed2006

[Extensor tendon injuries of the hand].

The treatment of extensor tendon injuries of the hand is based on Verdan's division of the different sections into eight zones. Taking the anatomic characteristics of those zones into consideration, good functional results can be achieved in most cases by differentiating between indications for operative or conservative treatment. The most frequent extensor tendon injury of the hand is the closed tendon rupture over the DIP joint. In almost all cases it can be completely cured by immobilization for at least 8 weeks. Open extensor tendon injuries on the other hand require surgical therapy. This paper gives a clearly arranged overview of the different therapeutic options.

Adult↗
PubMed2001

Functional outcome of high-pressure injection injuries of the hand.

BACKGROUND: High-pressure injection (HPI) injury of the hand is a serious injury that can be potentially devastating. There have been a number of publications on the results of its treatment, but we are not aware of a report on the functional outcome of these hands. METHODS: We assessed the functional outcome of 15 patients with HPI injuries. All patients were treated operatively, with a mean delay of 11.7 hours. The patients were examined by a doctor and an occupational therapist using a work simulator. RESULTS: Our study revealed a significant reduction of static and dynamic muscle testing parameters compared with the uninjured hand. Six patients lost a digit and four patients had to change their occupation after the injury. CONCLUSION: Deterioration of hand function is a predictable outcome of HPI injury. This information should be shared with the patient at the outset so as to avoid subsequent disappointment.

Adult↗
PubMed2004

Home treadmill injuries in infants and children aged to 5 years: a review of Consumer Product Safety Commission data and an illustrative report of case.

Approximately 8700 injuries from home exercise equipment occur annually in children in the United States. Home treadmills, which have been growing steadily in popularity during the past decade, pose a specific hazard to infants and children aged 5 years or younger, a population at increased risk of injury to the upper extremities (ie, arm, forearm, wrist, hand, and fingers). The authors also provide an illustrative report of case of a 2-year-old boy whose hand injury resulted from a home treadmill. Analysis and frequency reporting of United States Consumer Product Safety Commission data for home treadmill injuries in this demographic group are presented. From January 1, 1996, to September 30, 2000, the number of home treadmill injuries reported to the National Electronic Injury Surveillance System was 1009. Three hundred of these (29.7%) were in infants and children aged to 5 years. Abrasions or contusions (or both) of the upper extremities were the most common injury. Although the number of home treadmill injuries to children being reported is low, the potential for costly and serious complications has been demonstrated previously. The authors conclude that additional home treadmill safety measures and guidelines must be established.

Accidents, Home↗
PubMed1987

[Stonefish stab injury of the hand].

The authors report a sting injury by a stonefish in the hand. First aid and surgical treatment are discussed. The biology of the stonefish is reviewed.

Adult↗
PubMed2004

Hand and wrist injuries: Part II. Emergent evaluation.

Primary care physicians must be able to recognize wrist and hand injuries that require immediate attention. A complete history and physical examination, including assessment of distal limb function, are essential. Hemorrhage control is necessary in patients with vessel lacerations and amputations. Amputations require an understanding of the indications and contraindications in the management of the amputated limb. High-pressure injection injuries and compartment syndromes require a high index of suspicion for early recognition. Infectious entities include "fight bite," open fractures, purulent tenosynovitis, animal bites, and retained foreign bodies. Tendon disruptions should be recognized early to optimize management.

Amputation, Traumatic↗
PubMed1991

Providing care for hand disorders: trauma and elective. The Derby Hand Unit experience (1989-1990)

Data was collected prospectively on all patients from one health district attending the Hand Unit at Derbyshire Royal Infirmary to determine the needs for hand surgery and the resources utilised to meet them. 475 patients per 100,000 population presented with hand injuries and 289 patients per 100,000 with elective hand disorders each year. For every 100,000 population, the trauma cases required 139 inpatient days and 1723 outpatient visits. Elective cases required 221 inpatient days and 1039 outpatient visits.

Adult↗
PubMed1984

The use of the osteocutaneous groin flap in gunshot wounds of the hand.

Since 1972, the groin flap has been used as an excellent source of skin coverage for the hand. This flap can incorporate the underlying iliac crest to provide both soft tissue and vascularized bone for the reconstruction of complex hand injuries. Three patients who sustained gunshot wounds of the hand with loss of the thumb metacarpal and extensive soft tissue were treated with a groin flap that included the iliac crest. Bony union was rapid and thumb stability was excellent in all patients 3 months after initial reconstruction. The advantages of the osteocutaneous flap include the ability to: (1) supply vascularized bone to what is frequently a poor recipient bed for a bone graft, (2) reconstruct both soft tissue and bony defects simultaneously, and (3) be used in facilities without capability for microvascular surgery.

Adult↗
PubMed1989

[Blast injuries of the 1st commissure].

Explosions are responsible for severe hand injuries. Due to their extremely important functional role, lesions of the thumb and first commissure must be identified separately during assessment of the lesions. No classification of these injuries has been proposed since the one defined by Mac Gregor and Jackson. Based on their experience of 11 injuries, the authors propose a classification divided into four stages of increasing severity. In the emergency situation, the severe forms with disruption of the blood supply have a very poor prognosis. In the other forms, the degree of opening of the first commissure is of fundamental importance. Secondarily, the functional prognosis of the hand is dominated by retraction of the first commissure, ankylosis of the trapezo-metacarpal joint or its preservation during amputations.

Adolescent↗
PubMed2006

Long-term follow-up of high-pressure injection injuries to the hand.

BACKGROUND: High-pressure injection injury is an injury caused by accidental injection of substances by industrial equipment. This injury may have devastating sequelae. The goal of this study was to assess the long-term outcome of high-pressure injection injury to the hand. METHODS: In this historical prospective study, patients who had previously sustained high-pressure injection injury were examined. Assessment included measurement of grip and pinch strength, range of motion, two-point discrimination, and use of a questionnaire regarding present complaints and return to the work force. RESULTS: Twenty-three patients were examined. Follow-up length was on average 8.5 years. The injured hand was most often (43 percent) the right dominant hand, the index in 65 percent, the thumb in 25 percent, and other locations in 10 percent. Only 43 percent of patients returned to their previous employment. Patient complaints were, in descending frequency, cold intolerance, hypersensitivity, paresthesias, constant pain, and impairment of activities of daily living. Metacarpophalangeal range of motion was decreased on average by 8.1 percent (p = 0.019), proximal interphalangeal joint range of motion was decreased by 23.9 percent (p = 0.001), and distal interphalangeal range of motion was decreased by 29.7 percent (p= 0.018). Maximum grip was decreased compared with the expected grip by 12 percent (p = 0.023). Pinch was decreased by 35 percent (p < 0.001). Two-point discrimination was increased by 49 percent (p < 0.007). CONCLUSION: This study confirms the fact that high-pressure injection injury to the hand is a significant problem. Virtually all patients suffer sequelae of this injury. The injury has significant repercussions for future function and reintegration into the work force.

Accidents, Occupational↗
PubMed1989

Rehabilitation of common athletic injuries of the hand and wrist.

Rehabilitation of athletic injuries of the hand and wrist should begin at the time of injury. Early recognition and prompt medical attention can serve to minimize the initial effects of injury. A systematic evaluation should include assessment of deformity, joint instability, active and passive motion, edema, and nerve and tendon function. In spite of initial negative findings, painful joints should be protected. Joints of the hand and wrist are particularly vulnerable to the effects of aggressive rehabilitation. Signs of reaction to exercises should be closely observed. Upgrading of activity should only occur as soft-tissue healing will allow.

Athletic Injuries↗