• Title/Summary/Keyword: hand injury

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Clinical Evaluation of Pediatric Hand Injury (소아의 수부손상에 대한 임상적 고찰)

  • Kim, Jeong-Jin;Kim, Jeong-Cheol;Suh, Dong-Bo;Choi, See-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.202-208
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    • 1991
  • Hand injury in children was increased due to multiple environmental risks and failed attention of parents to children in rapidly developing society. By the results of this evaluation in 37 cases, it was summarized as follows. First, hand injuries in children most commonly occurs in spring, and occurs more commonly in the children at the age of high activity. The most common level of injury is zone I by microreplantation zone, and zone II by tendon injury zone. The more desirable results were obtained by full thickness skin graft and composite graft if it were possible. For the better functional results compare to adults, the methods and procedures must be constructed after more evaluation with more clinical cases. In the cases of pediatric hand injury, the most important fact is prevention of injury, with the close attention by parents, and the second is appropriate diganosis and treatment for more functional results.

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Hyperbaric oxygen therapy for the treatment of a crush injury of the hand: a case report

  • Neto, Pedro Henry;Ribeiro, Zamara Brandao;Pinho, Adriano Bastos;Almeida, Carlos Henrique Rodrigues de;Maranhao, Carlos Alberto de Albuquerque;Goncalves, Joaquim da Cunha Campos
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.209-214
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    • 2022
  • We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

Epidemiologic study of hand and upper extremity injuries by power tools

  • Kim, Yong Hun;Choi, Jin-hee;Chung, Yoon Kyu;Kim, Sug Won;Kim, Jiye
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.63-68
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    • 2019
  • Background Hand injuries caused by chain saws, electric saws, and hand grinders range from simple lacerations to tendon injuries, fractures, and even amputations. This study aimed to understand the distribution of various types of hand and upper extremity injuries caused by power tools, in order to help prevent them, by investigating the incidence and cause of power tool injuries treated over a 4-year period at a single institution in Korea. Methods We reviewed the medical records of patients who visited a single institution for power tool-induced injuries from 2011 to 2014. The distribution of sex, age, injured body part, type of injury, and mechanism of injury sustained by patients who received hand and upper extremity injuries from using an engine saw, electric saw, or hand grinder was evaluated. Results Among 594 subjects who were injured by power tools, 261 cases were hand and upper extremity injuries. The average age was 53.2 years. Tendon injury was the most common type of injury. An electric saw was the most common type of power tool used. More injuries occurred in non-occupational settings than in occupational settings. Conclusions In this study, power tool-induced hand and upper extremity injuries were mostly caused by direct contact with electric saw blades. More injuries occurred due to non-occupational use of these tools, but the ratios of amputations and structural injuries were similar in the non-occupational and occupational groups.

Analysis of 344 Hand Injuries in a Pediatric Population

  • Jeon, Byung-Joon;Lee, Jung-Il;Roh, Si Young;Kim, Jin Soo;Lee, Dong Chul;Lee, Kyung Jin
    • Archives of Plastic Surgery
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    • v.43 no.1
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    • pp.71-76
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    • 2016
  • Background The purpose of this study was to identify comprehensive hand injury patterns in different pediatric age groups and to assess their risk factors. Methods This retrospective study was conducted among patients younger than 16-year-old who presented to the emergency room of a general hospital located in Gyeonggi-do, Republic of Korea, and were treated for an injury of the finger or hand from January 2010 to December 2014. The authors analyzed the medical records of 344 patients. Age was categorized according to five groups. Results A total of 391 injury sites of 344 patients were evaluated for this study. Overall and in each group, male patients were in the majority. With regard to dominant or non-dominant hand involvement, there were no significant differences. Door-related injuries were the most common cause in the age groups of 0 to 3, 4 to 6, and 7 to 9 years. Sport/recreational activities or physical conflict injuries were the most common cause in those aged 10 to 12 and 13 to 15. Amputation and crushing injury was the most common type in those aged 0 to 3 and 4 to 6 years. However, in those aged 10 to 12 and 13 to 15, deep laceration and closed fracture was the most common type. With increasing age, closed injuries tended to increase more sharply than open injuries, extensor tendon rupture more than flexor injuries, and the level of injury moved proximally. Conclusions This study provides a comprehensive overview of the epidemiology of hand injuries in the pediatric population.

Injury of Corticostriatal Tract between the Striatum and the Premotor Area in a Patient with Traumatic Brain Injury

  • Kwon, Jung-Won;Seo, Jeong Pyo
    • The Journal of Korean Physical Therapy
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    • v.32 no.6
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    • pp.391-393
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    • 2020
  • Objectives: We investigated injury of corticostriatal (CStr) tract in patient with mild traumatic brain injury (mTBI), which was demonstrated by DTT. Method: A 44-year-old female with no previous history of neurological, physical, or psychiatric illness had suffered from head trauma resulting from a pedestrian car accident. She complained that could not quickly move the left hand with her intension. After three month's administration, her slowness movement of left hand recovered rapidly to the point that she was able to extend all fingers quickly. Results: On DTT configuration, the integrity of the left CStr tract was well-preserved, however the right CStr tract showed narrowing and partial tearing in the subcortical white matter on a DTT at 25 months after onset. Conclusion: Injury of the right CStr tract was demonstrated in a patient who developed mild motor control problems following mild TBI. We believe that the evaluation of the CStr tract from the secondary motor area for patients who showed unexplained motor control problem is necessary.

The Effectiveness of Hand Acupressure in Relieving Constipation among Patients with Paraplegia (수지요법이 하반신마비 환자의 변비완화에 미치는 효과)

  • Kim, Yeoun-Ok;Choi, Soon-Ock
    • Journal of East-West Nursing Research
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    • v.24 no.2
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    • pp.130-138
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    • 2018
  • Purpose: The purpose of this study was to determine the effectiveness of hand acupressure in relieving constipation among patients with paraplegia. Methods: Data were collected from a total of 52 participants with paraplegia from a spinal cord injury. Data were analyzed by chi-square test and t-test using SPSS/WIN 21.0. Results: The numbers of bowel movements per week increased in the experimental group who have received hand acupressure increased as compared with the control. Satisfaction with defecation of the experimental group improved as compared with the control. The level of constipation in the experimental group decreased compared to the control. Conclusion: We found that hand acupressure is effective in relieving constipation among patients with paraplegia from a spinal cord injury.

Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients

  • Kyung-Chul, Moon;Yu-Kyeong, Yun
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.261-267
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    • 2022
  • Purpose: With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center. Methods: Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments. Results: The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department. Conclusions: The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

Immediate Toe-to-Hand Transfer in Acute Hand Injuries (급성 수부 손상시 즉시 족지 전이술)

  • Woo, Sang-Hyun;Kim, Hak-Soo
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.19-28
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    • 2002
  • From 1994-2001, 25 mutilated digits were reconstructed with immediate toe-to-hand transfer in acute hand injury in 21 patients. There were 15 cases of great toe-to-hand transfer(partial great toe transfer 8 cases, modified wrap-around procedure 2 cases, and trimmed great toe transfer 2 cases) for thumb reconstruction, 2 cases of second toe transfer for index reconstruction, and 4 cases of simultaneous two toe-to-hand transfer(great toe & second toe transfer 1 case, bilateral second-toe transfer 2 cases, combined second & third toe transfer 1 case) for reconstruction of multiple digit amputations. Two cases of emergency exploration(2/25, 8%) were successfully salvaged. The incidence of emergency exploration and postoperative infection was not significantly different from that of the elective toe-to-hand transfer cases. Duration of industrial insurance coverage was 225 days, which is much shorter than that of elective cases. Among 43% of patients maintained their original job even after injury and immediate toe-to-hand transfer. The subjective satisfaction self- assessment scores of aesthetic appearance and function on the new reconstructed thumb were 80 and 88 in average, respectively, over a total score of 100. These were higher than those of reconstruction of other digits, but lower than those of elective reconstruction. The donor site after harvest of the great toe was mostly unsatisfied in a view of appearance. Immediate toe-to-hand transfer provides many advantages over elective procedure in acute hand injuries such as single stage reconstruction, shortened convalescent period, early return to work and efficient socio-economic factor. Furthermore because there were no significant differences in success rate, frequency of complications or ultimate functional result, immediate toe-to-hand transfer is a safe and reliable procedure in case of limited indications for acute digits loss.

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A Retrospective Analysis of 101 Cases of Distal Digital Replantation (수지 첨부 재접합술 101예의 후향적 분석)

  • Oh, Se-Kwan;Kim, Kyung-Chul;Lee, Gi-Jun;Kim, Joo-Sung;Mun, Hyun-Sik;Woo, Sang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.15 no.1
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    • pp.10-16
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    • 2006
  • We retrospectively evaluated our results of replantations of distal digital amputations and analyzed the factors deterrent to the survival of replanted digits. From January 2004 to 2005 June, we performed 101 cases of replantations following complete amputations at or distal to interphalangeal joint level. The study included 98 patients with a mean age of 35.6 years (range 1 to 63 years). Amputation level correlated to zone I (distal to the lunula)in 47 cases and zone II (lunula to distal interphalangeal joint) in 54 cases according to Yamano's classification. According to the mechanism of amputation, 24 cases (22.9%) suffered from guillotine type injury, 27 cases (27.1 %) from avulsion type injury and 50 cases (50%) from crush type injury. In all cases, a single arterial anastomosis was performed. Venous anastomosis on either volar or dorsal side was performed in 12 cases of amputation in zone II. Salvage procedure for venous drainage was performed in 98 cases. The mean duration of salvage procedures was 5.9 days (ranging from 4 to 14 days). Successful replantation was achieved in 96 cases (95.1%), which included 93.7% cases in zone I amputations and 96.3% cases in zone II amputations. A single venous anastomosis was performed in 12 cases of amputation in zone II. All of them survived completely. Among the 5 cases that failed to survive, 3 cases were related with avulsion injury in zone I. Initial mechanism of injury determines the survival rate of amputated parts as it is directly related with the status of vessels and soft tissues. Meticulous precaution during the salvage procedure may affect the overall survival rate of distal digital replantations.

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Effects of Splints on Hand Function in Person with Traumatic Brain Injury (외상성 뇌손상 환자의 손보조기 적용이 손기능에 미치는 효과)

  • Kim, Eun-Joo
    • Journal of Digital Convergence
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    • v.16 no.7
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    • pp.511-516
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    • 2018
  • This study examined the effectiveness of a short thumb splint and a glove type splint which combined features of a fitness glove in order to improve hand function and performance of functional task after traumatic brain injury. One subject with traumatic brain injury participated in this study and wore a short thumb splint and customized glove type splint. His hand function was significantly improved when comparing to that of not using those splints. In addition, using the glove type splint was more significant to perform functional tasks than using the short thumb splint. The findings of this study identified that hand function of people with traumatic brain injury was improved by using those splints as an occupational therapy service and it is necessary to adapt the customized splints according to the personal characteristics.