Injuries of the fingers and hands; a review of cases from the standpoint of compensation.
(33/236)
Review of records in cases of injury to the hand that come before the California Industrial Accident Commission indicate that:1. Primary closure at a suitable level in finger amputations is often preferable to plastic repair.2. Complications incident to plastic repair in minor injuries frequently increase disability and cost to employer.3. Tendon injury resulting from strain is a frequently overlooked cause of disability. (+info)
Crushing injury of the hand; prevention of ischemic contracture.
(34/236)
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. (+info)
Impalement injuries of the hand: repair of damage from broken bean poles.
(35/236)
A not uncommon injury of the hands among agricultural workers is impalement on the sharp ends of tomato-vine or bean-vine stakes that shatter as they are being driven. Careful debridement and tetanus prophylaxis are important in treatment. There are several simple precautions and changes in work methods that could greatly reduce the incidence of such injuries. (+info)
Injuries of the hand and forearm; treatment of damaged soft tissues.
(36/236)
Successful primary repair of soft tissue injuries of the hand and forearm holds the ultimate disability to a minimum. The kinds of trauma and the resultant soft tissue damage may be classified. Attention to details and technique in carrying out the primary reparative operation on the injured hand largely obviates a crippling deformity or the need for much reconstruction later. (+info)
Fracture of the metacarpal shaft. A method of treatment.
(37/236)
Anatomically, metacarpal fractures, when reduced, are not spontaneously stable. They require maintenance of this reduction because of the forces acting on the fragments. Closed methods of maintaining this reduction are ideal, but in selected cases, intramedullary fixation of the fracture, using the Kirschner wire, gives excellent results. The method under consideration does not disturb the fracture site itself, the Kirschner wire being introduced "blind." Correct placement of the site of insertion of the wire, coupled with the rigid immobilization thus attained, gives excellent results in a high proportion of selected cases. (+info)
Alcohol-related hand injuries: an unnecessary social and economic cost.
(38/236)
Severe hand injuries constitute the largest number of acute referrals to this plastic surgery unit, the admission of these patients often displacing routine admissions due to bed shortages, thus increasing waiting list time. This study showed that a high percentage of these injuries were alcohol-related and were therefore preventable. The economic cost to the unit is discussed. (+info)
INJURIES OF THE UPPER EXTREMITY. THE ROLE OF THE RECONSTRUCTIVE SURGEON.
(39/236)
Proper primary care of the injured hand minimizes both temporary and permanent disability. It is essential that the physician undertaking the primary management and treatment of an injured hand appreciate the problem and understand the available procedures and techniques. Thoughtful examination of the injured part, noting loss of voluntary motion or any absence of sensation, and adequate x-ray studies will assist in outlining the appropriate immediate care. By carefully and thoroughly debriding the wound, restoring bony anatomical alignment and obtaining satisfactory skin cover, the stage is set for maximum salvage of the injured hand. By evaluating the time interval (minutes to 12 hours since injury), as well as the type of injury (laceration, crush, or avulsion trauma) and the structures involved (fractures, cut nerves and tendons, skin loss), one can properly undertake the primary repair of the damaged tissues. The choice between primary or delayed tendon and nerve repair should be carefully weighed, dressing applied judiciously and correct splinting carried out so as to minimize ultimate deformity and disability. Rehabilitative measures including voluntary exercise by the patient should be begun early. (+info)
Physical medicine for injured hands.
(40/236)
The functional concepts of treatment of the injured hand by use of the various modalities of physical medicine, including heat, massage, electrical stimulation, passive exercises, active exercises, occupational therapy and splints are discussed. Immobilization is often necessary to correct anatomical injuries. Mobilization activities using physical medicine are just as necessary to correct functional deficiencies of the hand occurring either from the injury or the enforced immobilization following an injury. (+info)