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At least 19 recordsLinked to original sources
PubMed1992

Hand and forearm injuries from penetrating projectiles.

Compared with other surgical literature published after the Vietnam and Persian Gulf wars, hand surgery literature has been relatively void of information regarding projectile injury. Wound ballistics research of the past 10 years has shown that objective evaluation of tissue disruption is the only valid guide to treatment. The hand's anatomy requires hand surgeons to be more careful in tissue excision. Hand surgeons, therefore, do not have the luxury of "cutting till it bleeds." The purpose of this article is to support the methods that hand surgeons have traditionally used and to caution the inexperienced surgeon who may be inclined to excise uninjured tissue.

Animals↗
PubMedDate not supplied

A prosthetic appliance for a patient with a brachial plexus injury and forearm amputation: a case report.

Among the prosthetic and orthotic appliances available, neither a conventional mechanical prosthesis nor the myoelectric control system provided optimal results for a 19-year-old patient with a traumatic, irreversible paralysis of the brachial plexus and below-elbow amputation. A new device was therefore constructed that combined the mechanical pull of the first system and the electric hand of the second. Its functions, the training program, and the end result are reported.

Adult↗
PubMed1979

Forearm arterial injuries.

The effects of single forearm arterial injuries with and without associated neurological injuries were studied. Fifty subjects were evaluated: seven patients with isolated arterial lacerations, 15 patients with isolated nerve lacerations, 13 patients with combined nerve and arterial injuries, and 15 control subjects. A series of noninvasive peripheral vascular studies were correlated with the symptoms produced by a controlled cold-environment exposure. The hemodynamic alterations associated with symptoms of hand ischemia, and particularly with cold intolerance, were studied. Unrepaired single arterial injuries caused modest, consistent alterations in hand vascularity, but few signs of ischemia or symptoms of cold intolerance. The remaining intact artery demonstrated a consistent increase in flow velocity. Combined nerve and artery injuries caused the most significant alterations in hand vascularity, and median nerve and associated artery injuries caused the most disabling symptoms. Single arterial lacerations had no effect on the rate or completeness of recovery from associated nerve injuries.

Arteries↗
PubMed1992

Severe electric injuries of the hand and forearm.

Electrical injuries of the upper limb produce major destruction of tissue mainly affecting the forearm, since the hand is usually the site of entry of current. Limb salvage, if it is to be successful, requires the rapid institution of a number of surgical procedures. Vein grafting to restore blood supply is frequently required and just as frequently requires skin flap cover following adequate debridement. The most commonly used flap is the groin flap. Despite the progression of necrosis beneath the flap for a period of up to three weeks, healing is usually successful and it is usually possible to avoid amputation. Several surgical procedures are required as a rule. The initial surgery is followed, in order, by nerve graft, tendon transfer and skin transfer following the use of tissue expanders. Results long term, with regard to function and appearance, were judged good.

Adolescent↗
PubMed1992

Double injuries of the forearm: a common occurrence.

To evaluate the frequency of different types of forearm fractures and, in particular, determine the frequency of double injury to the forearm, the authors prospectively examined 119 consecutive forearm fractures and found double injuries to the forearm in all but five cases. In 79 of the 119 patients (66%), ligamentous injury was seen in addition to the obvious fracture. Nine patients with apparent isolated fractures on initial radiographs underwent examination by means of radionuclide bone scanning, which revealed a second injury in eight of them. Four patients with apparent single fractures did not undergo bone scanning because of their critical conditions. In four patients, a single fracture was initially diagnosed, but after reduction and casting, dislocation of the radioulnar joint was seen. These findings indicate that injury to the forearm almost invariably occurs at two or more sites and involves either both bones or bone and ligament. Because the distal radioulnar joint was affected in 71 patients (60%), scrutiny of the wrist is imperative whenever injuries to the bones of the forearm are discovered.

Arthrography↗
PubMed1976

Reconstruction of the thermally injured upper extremity.

A rational approach to the restoration of function of the upper extremity has been outlined for the burned patient. If these guidelines are followed and the joints of the upper extremity approached individually with a goal of restoring as much range of motion as possible, great functional improvement may be anticipated. The surgical procedures must be augmented with vigorous PT and strong patient motivation. With this combination improvement of function of the upper extremity can be provided that is gratifying to both the surgeon and the patient.

Amputation, Surgical↗
PubMed1992

Management of acute and chronic vascular injuries to the arm and forearm. Indications and technique.

Acute arterial injuries of the upper extremity account for half of civilian arterial injuries in the United States. The great majority of these injuries are due to penetrating trauma, with stab wounds and gunshot wounds being the most common cause. The history of the injury and a careful physical examination will identify most injuries. Arteriography should be performed when a vascular injury is suspected but not confirmed by physical examination. Reconstruction of critical vascular lesions is essential for restoration of flow distally. Noncritical lesions may be repaired in most cases, with long-term patency rates averaging 50% to 68%. Although amputation is uncommon after upper-extremity vascular injury, long-term disability can be significant in those patients with concomitant nerve injury. Chronic upper-extremity ischemia may be secondary to atherosclerotic occlusive disease, aneurysms, or arteriovenous fistulas. Angiography will delineate the diseased or occluded arterial segment, allowing bypass to be successful in more than 90% of cases. With careful attention to proper diagnosis and treatment, good to excellent long-term relief of symptoms can be obtained.

Acute Disease↗
PubMed1992

Subclinical injuries in lacerations to the forearm and hand.

This report describes the incidence and severity of subclinical injuries to underlying structures in lacerations to the hand and forearm. One hundred consecutive hand and forearm lacerations that penetrated the full thickness of subcutaneous tissue were studied prospectively. Lacerations were explored under either biceps or forearm tourniquets. Injuries, treatment, tourniquet time, causative agent and complications were recorded. In all, 97 patients sustained 100 lacerations. A total of 49 deep injuries were discovered, none of which was detected clinically before exploration. Of these, 33 were tendon lacerations; 21 tendons, including three flexor tendons, were repaired. Nineteen patients required treatment in a volar slab for at least 3 weeks. Five patients of 49 returning for review developed wound infection. No patient developed significant problems related to the tourniquet, which was inflated for a mean time of 4.9 min. There is a high incidence of subclinical injury in full-thickness lacerations of the forearm and hand. These should be explored under tourniquet, which should minimize complications such as wound infection and delayed tendon rupture.

Forearm↗
PubMed1992

[Monteggia injuries in athletes. Causes, classification, results].

Monteggia-fractures are serious combination injuries to the forearm. Sport injuries are being increasingly observed; the reason for this, besides the general expansion of mass sports, is the increasing burden of high-performance sports. Monteggia fractures can occur during a fall on an outstretched arm, for example in motor or bicycle sport injuries, but also when falling from gymnastic equipment. Generally, it is easy to diagnose the monteggia injury. Considerable secondary damage could occur from the frequent failure to notice the involved radiohumeral joint. It should be demanded that in case of an uluar fracture the adjoining joints should be x-rayed on two planes in order not to overlook the possibility of a chisel fracture. The different forms of this combination injury, its classification and the results of our own medical bulletins are presented.

Athletic Injuries↗