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At least 19 recordsLinked to original sources

Clinical and socio-economical aspects of hand injuries.

A prospective investigation of all hand injuries seen at a major general hospital during a period of one year has been made. Over 900 hand injuries have been registered and systematically been followed up during the period of treatment. The survey includes the frequency, severity and treatment of the hand injuries. Furthermore there is an estimation of the medical and socio-economical consequences of the hand injuries. It is shown that hand injuries are extremely usual and imply enormous costs to the community. Postgraduate tranining in hand surgery is therefore desirable for all those general and orthopaedic surgeons, who deal with the treatment of patients with hand injuries.

Accidents

Predictive value of psychological screening in acute hand injuries.

Difficulties in adjustment frequently accompany severe hand injuries. The purpose of this study was to determine whether presurgical screening could predict long-term adjustment problems. One hundred thirteen patients with severe hand injuries completed a presurgical questionnaire evaluating flashbacks, avoidance, and causal factors pertaining to the injury. Patients were evaluated by a psychologist within 5 days after surgery and again 6 months later. Flashbacks initially occurred with equal frequency in occupationally and nonoccupationally injured groups. At 6-month follow-up 50% of the occupationally injured patients and 25% of the nonoccupationally injured patients had flashbacks. Avoidance of the activity at which patients were injured was also assessed. Among occupationally injured patients, 52% initially reported no avoidance compared with 17% at follow-up. Patients with nonoccupational injuries showed more initial avoidance (68%), with slightly less at follow-up (61%). Of the occupationally injured patients, 46% initially reported personal error or fatigue as the cause of their injury, but only 6% reported this as the cause at follow-up; it is interesting that at 6-month follow-up 81% of this group reported machine failure or lack of safeguards. Among nonoccupationally injured patients, 71% reported personal error as the cause of injury presurgically and 66% at 6-month follow-up. Presurgical screening appears to be a valid means of identifying persons at risk of ongoing adjustment problems after hand injury. A screening interview can easily be conducted in less than 5 minutes.

Accidents, Occupational

Quantitative microbiology: its application to hand injuries.

Quantitative microbiologic analysis of civilian hand injuries has been accomplished in thirty-four patients. Most traumatic soft tissue injuries exhibited an insignificant level of contamination. The number of bacteria recovered from most of those wounds was comparable to that encountered in clean elective surgical hand cases. We now view most civilian hand wounds as clean wounds carrying a very low risk of infection. Our patients with traumatic hand injuries are considered candidates for immediate reconstruction, which includes vascular, bony, or neural repair as well as immediate implantation of Silastic rods in preparation for subsequent tendon grafting.

Bacteriological Techniques

Dupuytren's disease--the influence of occupation and previous hand injuries.

The influence of handedness, work and previous hand trauma is studied in 901 persons with Dupuytren's disease, collected in an epidemiological study of 15,950 citizens in a small, Norwegian town. Dupuytren's disease occurred in all occupational groups, but the prevalence was higher and the contracture more severe in people doing hard manual work than in people doing light or non manual work. Persons with Dupuytren's disease has sustained previous hand trauma more frequently than the general population, and the interval between trauma and first sign of disease was usually a few years. Previous hand injuries were definitely more common among people doing hard manual work, but even when these were excluded from the work material, Dupuytren's disease was still more common among people doing hard manual work, than in people doing light or non manual work. The study has indicated that Dupuytren's disease in certain cases is precipitated and/or aggravated by both work and definite hand injury.

Aged

Bacterial colonization of mutilating hand injuries and its treatment.

A total of 120 hand injuries were reviewed. Sixty-seven occurred between 1965 and 1972 and were analyzed retrospectively, and 53 occurred between 1972 and 1974 and were analyzed prospectively. The bacterial colonization was determined in 86 injuries. Injuries sustained while handling farm implements tended to be colonized by mixed gram-negative and gram-positive isolates. The gram-negative isolates usually were resistant to all antibiotics, with the exception of gentamicin. However, nine bacterial isolates were resistant to all agents tested. Injuries sustained in the home or industry were colonized by gram-positive organisms. Most were susceptible to semisynthetic penicillinase-resistant penicillins such as methicillin and its congeners. The use of parenteral prophylactic antimicrobial agents in the treatment of mutilating hand injuries was not significant in preventing infection, and their use does not seem to be indicated in farm implement-related injuries. Antimicrobials are of value in home- and industrial-related injuries only when the status of the wound so indicates.

Anti-Bacterial Agents

Hand injuries in volleyball.

We studied the long-term sequelae of hand injuries as a result of playing volleyball. In a retrospective study, 226 patients with injuries of the hand who were seen over a 5-year period at our Trauma Department, were investigated. Females accounted for 66% of all injuries. The mean age was 26 years, with a peak in the age group of 15 to 29 years. Sprains and strains were observed most frequently (39%), followed by fractures (25%) and contusions (16%). The fingers were involved in 44% of the cases. Most injuries of the hand occurred in recreational players. Recreational players had more left-sided injuries, whereas competition players had more right-sided injuries (P less than 0.005), suggesting that lack of skill is an important determinant. Left-handedness was associated with an increased risk of hand injury in recreational players. One third of the volleyball players did not go to work or school for a median of 4 weeks as a result of the injury. In a survey after a mean period of 5 years, a high percentage of patients had complaints: 28% cited stiff and crooked fingers with limitations and tenderness in the movements as main inconveniences. We consider this incidence disturbingly high, regarding the seemingly innocent nature of these injuries.

Adolescent