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Abstract
Injuries to the hand by sea urchin spines are not commonly seen in the United Kingdom. There are many varieties of sea urchins (Echinoidea) throughout the world. They have a spherical calcium carbonate exoskeleton covered with spines. Certain varieties may be venomous, in particular the flower urchin ( Toxopneustes pileolus) found in the Indo-Pacific oceans. Injury may also be caused by the urchin spines or pedicellaria (delicate seizing organs equipped with jaws) ( Auerbach, 1991 ; Smith, 2002 ). A small number of hand injuries associated with sea urchin spines have been reported in the literature.
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Affiliation(s)
- R Nassab
- Department of Plastic Surgery, University Hospital Birmingham NHS Trust, Selly Oak Hospital, Birmingham, UK.
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Kamrani RS, Reza Shahriar K, Taheri A, Afshin T, Jalali Mazlouman S, Shahriar JM. Closed Multiple Tendinous Rupture of Flexors and Extensors of Hand: A Case Report. ACTA ACUST UNITED AC 2016; 29:632-3. [PMID: 15542230 DOI: 10.1016/j.jhsb.2004.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2004] [Accepted: 07/09/2004] [Indexed: 11/17/2022]
Abstract
Multiple ruptures of the extensor and flexor tendons of the fingers, thumb and wrist at the musculotendinous junctions are reported after a blast injury.
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Affiliation(s)
- Reza Shahriar Kamrani
- Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran 14114, Iran.
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53
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Hong JY, Oh JH, Kim CW, Lee DH. Hand injuries caused by feedback device usage during cardiopulmonary resuscitation training. Resuscitation 2016; 107:e3-4. [PMID: 27521475 DOI: 10.1016/j.resuscitation.2016.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 08/03/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Jun Young Hong
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Je Hyeok Oh
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
| | - Chan Woong Kim
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Dong Hoon Lee
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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54
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Orbach H, Rubin G, Wolovelsky A, Rinott M, Giwnewer U, Rozen N. [HAND INJURIES IN ROCK CLIMBERS]. Harefuah 2016; 155:407-409. [PMID: 28514129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Rock climbing, whether practiced in nature on cliffs and boulders or indoors on walls made of resin and wood, has gained tremendous popularity in recent decades. More people are exposed to injuries associated with the unique biomechanical forces of rock climbing. A series of repetitive high torque movements of the upper limbs are needed to ascend a wall or rockface. These movements subject the hand and wrist to large forces, potentially resulting in ligament and tendon sprains or rupture and even bone fracture. This review describes the anatomy, biomechanics and the common hand injuries in rock climbers.
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Affiliation(s)
- Hagay Orbach
- Orthopaedic Department, Ha'Emek Medical Center, Afula
| | - Guy Rubin
- Orthopaedic Department, Ha'Emek Medical Center, Afula
- Faculty of Medicine, Technion, Haifa, Israel
| | | | - Micha Rinott
- Orthopaedic Department, Ha'Emek Medical Center, Afula
| | | | - Nimrod Rozen
- Orthopaedic Department, Ha'Emek Medical Center, Afula
- Faculty of Medicine, Technion, Haifa, Israel
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55
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Zanon V, Morri A, Lonati D, Paoli A, Camporesi EM, Bosco G. HBO₂ in snake envenomation (atrox albinus rattlesnake): a case report in a human. Undersea Hyperb Med 2016; 43:473-476. [PMID: 28763178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A patient suffered from an envenomation that, at his hospitalization, was judged severe: Grade 3 out of 3, as defined in clinical studies for CroFab™ antidote [Crotalidae Polyvalent Immune Fab (Ovine)]. In addition to the usual antivenom treatment we applied adjunctive hyperbaric oxygen (HBO₂) therapy. Our aim was to facilitate better control of the lesions, already presenting as problematic wounds and at high risk of necrotizing soft tissue infection with compartment aspects. The regimen consisted of six treatments, one daily at 2.4 atmospheres absolute at 25 minutes x3 (75 minutes) at FiO₂=1, with two five-minute air breaks interposed. The therapy was well tolerated in spite of the patient's declared trait of claustrophobia. Our findings at a long-term follow up suggest that HBO₂ therapy may be reasonably and effectively administered at least in the post-acute phase of such occurrences.
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Affiliation(s)
- Vincenzo Zanon
- Renato Moroni DHMU, Brescia City Clinical Institute (ICCB), GSD University and Research Hospitals, Brescia, Italy
| | - Antonio Morri
- Emergency Department, San Marino National Hospital, Republic of San Marino
| | - Davide Lonati
- Clinical Toxicology and Poison Control Center, Pavia, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | | | - Gerardo Bosco
- Department of Biomedical Sciences, University of Padua, Padua, Italy
- CMI Domus Medica, Diving and Hyperbaric Medicine Unit (DHMU), Acquaviva, San Marino
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56
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McNamara AR, Ensell S, Farley TD. Hand Blisters in Major League Baseball Pitchers: Current Concepts and Management. Am J Orthop (Belle Mead NJ) 2016; 45:134-136. [PMID: 26991565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Friction blisters are a common sequela of many athletic activities. Their significance can range from minor annoyance to major performance disruptions. The latter is particularly true in baseball pitchers, who sustain repeated trauma between the baseball seams and the fingers of the pitching hand, predominately at the tips of the index and long fingers. Since 2010, 6 Major League Baseball (MLB) players accounted for 7 stints on the disabled list (DL) due to blisters. These injuries resulted in a total of 151 days spent on the DL. Since 2012, 8 minor league players spent time on the DL due to blisters. Moreover, there have been several documented and publicized instances of professional baseball pitchers suffering blisters that did not require placement on the DL but did result in injury time and missed starts. The purpose of this article is to review the etiology and pathophysiology of friction blisters with particular reference to baseball pitchers; provide an overview of past and current prevention methods; and discuss our experience in treating friction blisters in MLB pitchers.
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Affiliation(s)
| | | | - Timothy D Farley
- St. Louis Cardinals, Springfield, MO; Motion Orthopaedics, Creve Coeur, MO.
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57
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Pech J, Veigl D, Vlček M. [Spontaneous Tendon Ruptures in the Rheumatoid Hand]. Acta Chir Orthop Traumatol Cech 2016; 83:375-380. [PMID: 28026732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A spontaneous tendon rupture is a direct consequence of rheumatoid inflammation and can appear without any noticeable impact, often during sleep. The patient then presents with inability to flex or extend metacarpophalageal or interphalangeal joints. Multiple ruptures resulting in impaired function of several fingers can also occur and markedly limit the hand's grip strength. A tear may arise from either mechanical injury to the tendon along its course over bone or connective tissues, or by biochemical action of lysosomal enzymes, released during the inflammation process, on the connective tissue of the tendon. Ischaemic damage to a part of the tendon due to constriction of vessels supplying the peritenonium is found in hypertrophic peri-tenosynovitis. Spontaneous ruptures can be prevented, in the first place, by early synovectomy and then by a number of prophylactic procedures on soft tissues and carpal bones, which can stop or at least slow down the development of severe axial deformities of the wrist and hand. Simple end-to-end suture of the stumps is usually not possible; tendon repair surgery using free grafts or, more often, intact tendon transfer is necessary. In the flexor part, transfer of the superficial flexor tendon to a stump of the deep flexor tendon is frequently performed; a free graft can also be used at a two-stage tendon reconstruction. The repair of flexor tendons is technically more demanding and the results are less satisfactory compared to repair surgery on the extensor tendon. Key words: rheumatoid arthritis, metacarpophalageal joint, interphalangeal joint, tendon rupture.
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Abstract
African hair braiders are potentially subject to work-related musculoskeletal disorders (WMSDs) because they perform repetitive hand motions for many hours a day together with prolonged standing and/or prolonged sitting. A complete enumeration of African hair braiders was attempted in Oklahoma City (OKC) and Dallas/Fort Worth (DFW). Braiders were identified through the channels they typically use to offer services to clients. Potential risk factors and symptoms of WMSDs were assessed using an oral interview. Participation rates were 95% (18/19) in OKC and 83% (83/101) in DFW. More than 75% of braiders reported discomfort in the fingers, wrist/hand, upper back, and lower back. In multivariate analysis, years worked as a braider but not age was a significant risk factor (p < 0.005) for reported pain in the wrist/hand, time spent sitting during the work day was found to be a significant predictor (p < 0.05) of upper back pain and lower back pain, and time spent sitting and time spent standing during the work day were both significant predictors (p < 0.05) of shoulder pain. Braiders in OKC, where licensing requirements were stricter, were significantly more likely than braiders in DFW to work at home (67% vs. 4%, p < 0.001) and to report pain in the lower leg (p < 0.005) and ankle/foot (p < 0.05). The close-knit nature of the African hair braiding community makes it an appealing candidate for community-based participatory research aimed at further elucidating occupational health concerns and reducing risk.
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Affiliation(s)
- Oumy Sy
- a Department of Occupational and Environmental Health , College of Public Health, University of Oklahoma Health Sciences Center , Oklahoma City , Oklahama
| | - Margaret L Phillips
- a Department of Occupational and Environmental Health , College of Public Health, University of Oklahoma Health Sciences Center , Oklahoma City , Oklahama
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Postorino MC, Torti C, Carè I, Pisani V, Strazzulla A, Vaccaro V, Costa C, Provenzano F, Mazzitelli M, Pujia A, Montalcini T. Is hand-grip another culprit for the risk of fractures in HIV-positive patients? New Microbiol 2016; 39:61-64. [PMID: 26922987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 12/06/2015] [Indexed: 06/05/2023]
Abstract
Risk of bone fractures in patients with HIV infection is greater than in the general population, particularly in those co-infected with hepatitis viruses. We compared bone mineral density (BMD) and muscular strength, measured by hand grip test (HG), in HIV mono-infected and co-infected patients. T-score values were lower in HIV patients co-infected with hepatitis viruses vs. mono-infected individuals. Since no significant correlations between HG and T-scores were found, we hypothesize that these factors belong, at least in part, to independent pathways, so both should be taken into account as risks for fragility fractures. Larger prospective studies are needed to confirm this hypothesis.
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Affiliation(s)
| | - Carlo Torti
- Infectious Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Ilaria Carè
- Clinical Nutrition Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Vincenzo Pisani
- Infectious Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | | | - Vittoria Vaccaro
- Infectious Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Chiara Costa
- Infectious Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | | | - Maria Mazzitelli
- Infectious Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Arturo Pujia
- Clinical Nutrition Unit, "Magna Graecia" University, Catanzaro, Italy
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Lowndes BR, Heald EA, Hallbeck MS. Ergonomics and comfort in lawn mower handle positioning: An evaluation of handle geometry. Appl Ergon 2015; 51:1-8. [PMID: 26154198 DOI: 10.1016/j.apergo.2015.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 02/27/2015] [Accepted: 04/04/2015] [Indexed: 06/04/2023]
Abstract
Hand operation accompanied with any combination of large forces, awkward positions and repetition may lead to upper limb injury or illness and may be exacerbated by vibration. Commercial lawn mowers expose operators to these factors during actuation of hand controls and therefore may be a health concern. A nontraditional lawn mower control system may decrease upper limb illnesses and injuries through more neutral hand and body positioning. This study compared maximum grip strength in twelve different orientations (3 grip spans and 4 positions) and evaluated self-described comfortable handle positions. The results displayed force differences between nontraditional (X) and both vertical (V) and pistol (P) positions (p < 0.0001) and among the different grip spans (p < 0.0001). Based on these results, recommended designs should incorporate a tilt between 45 and 70°, handle rotations between 48 and 78°, and reduced force requirements or decreased grip spans to improve user health and comfort.
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Affiliation(s)
- Bethany R Lowndes
- Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Elizabeth A Heald
- Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - M Susan Hallbeck
- Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE, USA.
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61
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Lima C, Lima A, Degenhardt Ä, Valverde N, Da Silva F. Reconstructive dosimetry for cutaneous radiation syndrome. Braz J Med Biol Res 2015; 48:895-901. [PMID: 26445332 PMCID: PMC4617115 DOI: 10.1590/1414-431x20144337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/05/2014] [Indexed: 01/08/2023] Open
Abstract
According to the International Atomic Energy Agency (IAEA), a relatively significant number of radiological accidents have occurred in recent years mainly because of the practices referred to as potentially high-risk activities, such as radiotherapy, large irradiators and industrial radiography, especially in gammagraphy assays. In some instances, severe injuries have occurred in exposed persons due to high radiation doses. In industrial radiography, 80 cases involving a total of 120 radiation workers, 110 members of the public including 12 deaths have been recorded up to 2014. Radiological accidents in industrial practices in Brazil have mainly resulted in development of cutaneous radiation syndrome (CRS) in hands and fingers. Brazilian data include 5 serious cases related to industrial gammagraphy, affecting 7 radiation workers and 19 members of the public; however, none of them were fatal. Some methods of reconstructive dosimetry have been used to estimate the radiation dose to assist in prescribing medical treatment. The type and development of cutaneous manifestations in the exposed areas of a person is the first achievable gross dose estimation. This review article presents the state-of-the-art reconstructive dosimetry methods enabling estimation of local radiation doses and provides guidelines for medical handling of the exposed individuals. The review also presents the Chilean and Brazilian radiological accident cases to highlight the importance of reconstructive dosimetry.
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Affiliation(s)
- C.M.A. Lima
- Instituto de Radioproteção e Dosimetria, IRD/CNEN, Rio de Janeiro,
RJ, Brasil
| | - A.R. Lima
- Instituto de Radioproteção e Dosimetria, IRD/CNEN, Rio de Janeiro,
RJ, Brasil
| | - Ä.L. Degenhardt
- Instituto de Radioproteção e Dosimetria, IRD/CNEN, Rio de Janeiro,
RJ, Brasil
| | - N.J. Valverde
- Fundação Eletronuclear de Assistência Médica, Rio de Janeiro, RJ,
Brasil
| | - F.C.A. Da Silva
- Instituto de Radioproteção e Dosimetria, IRD/CNEN, Rio de Janeiro,
RJ, Brasil
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62
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Zbuchea A. Humeral Neck Fracture after Electrocution - Case Report and Literature Review. Chirurgia (Bucur) 2015; 110:490-492. [PMID: 26531798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 06/05/2023]
Abstract
A case of left humeral neck fracture following electrocution is reported in a 56-year old man, associated with partial thickness burns on his left hand. A fracture after accidental electrical shock injury represents a very unusual situation, due to muscle contractions. Surgeons involved in the management of the electrocuted patients should be aware of the possibility of musculoskeletal injuries. Neglecting these injuries can lead to delay in diagnosis and to detrimental complications.
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63
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Antabak A, Barišić B, Andabak M, Papeš D, Romić I, Fuchs N, Luetić T. [HAND FRACTURES IN CHILDREN - CAUSES AND MECHANISMS OF INJURY]. Lijec Vjesn 2015; 137:306-310. [PMID: 26749954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hand is extremely exposed to various loads and traumas of everyday tasks and activities, resulting in fist fractures being fairly common injuries. The most common mechanism of injury is a direct blow. This retrospective study analyzed the data on 274 children admitted for hand fractures at Clinical Hospital Center Zagreb in the period from 2006 to 2014. The study included 76 girls (28%) and 198 boys (72%). The average patient age was 11.9 years and most were between 10 and 13 years of age. Phalangeal fractures accounted for 80%, metacarpal fractures for 17%, and carpal fractures for 3% of all injuries. Most commonly injuries occurred during recreation (4 1%), at home (37%), at school (18%) and in the street (4%). Direct blow was the major cause of injury (76%), and 24% were caused by fall. Injuries during sport activities are the most common cause of the hand fractures in pediatric population and direct blow is the main mechanism of injury. The peak incidence is at the age of 10-13 years in boys and girls, so prevention should be aimed at this age group. Preventive actions should be focused on injuries that tend to occur in parks, schools and during sport activities.
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Zhou K, Krug K, Brogan MS. Management of a Dehisced Hand Wound Using Hydrogen Peroxide, Electrical Stimulation, Silver-containing Dressings, and Compression: A Case Study. Ostomy Wound Manage 2015; 61:32-37. [PMID: 26185974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Wound dehiscence is the separation of a wound along surgical sutures. A 57-year-old, otherwise healthy mechanic presented with a large open wound of >1 month duration on his left hand. His wound had dehisced after treatment that involved cleansing, surgical sutures, and oral antibiotics. He presented with a 5.0 cmx0.7 cmx0.3 cm lesion through the palmar creases of the hand with edema around the fourth and fifth digits and a callous formation around the distal portion of the wound. The wound had scant serosanguinous drainage and some induration at the periwound area, as well as a moderate foul odor. Tendons were not affected, but function was limited, the hand was painful, and the patient had been unable to work. Treatment was initiated with twice-a-week immersion of the hand in hydrogen peroxide diluted with water subjected to high-voltage pulsed current electric stimulation (HVPC). The wound was dressed with silver-containing dressings secured with stretch gauze and a compression garment. The wound was completely closed after 9 visits (35 days). No functional limitations of the hand or fingers, no cosmetic defect, and no wound recurrence were noted 9 months after healing. Although uncommon, dehisced wounds, especially in certain anatomical locations such as the hand, can be difficult to heal and may cause long-term problems with functioning. The treatment combination facilitated expedient healing of this dehisced hand wound. Research is needed to help elucidate the observations from this case study.
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Affiliation(s)
- Kehua Zhou
- Department of Health Care Studies, Daemen CollegePlease address correspondence to: Kehua Zhou, MD, DPT, LAc, Daemen College, 4380 Main Street, Amherst, NY 14226;
| | - Kenneth Krug
- Daemen College Physical Therapy Wound Care Clinic, Cheektowaga, NY
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Al-Jasser FS, Mandil AM, Al-Nafissi AM, Al-Ghamdi HA, Al-Qattan MM. Epidemiology of pediatric hand fractures presenting to a university hospital in Central Saudi Arabia. Saudi Med J 2015; 36:587-92. [PMID: 25935180 PMCID: PMC4436756 DOI: 10.15537/smj.2015.5.10527] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 03/16/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the epidemiology of pediatric hand fractures and to provide recommendations regarding prevention. METHODS Medical records and x-rays were retrospectively reviewed for age at the time of injury, gender, fracture pattern, place where the injury occurred, and mechanism of injury. The study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between January 2005 and December 2011. RESULTS Of 361 cases reviewed, there were 291 (80.6%) male and 70 (19.4%) female patients. Most (46.2%) were in the age group of 13-18 years. For age group 1-4 years, the most common place of occurrence was at home (81.3%) and for the group 13-18 years, outdoors was the place of occurrence (64.7%). Females were mostly injured at home while males had similar distribution of indoor and outdoor injuries. The most common causes of fractures were: door slams in the 1-8 years age group; falls at home, in the 9-12 years age group; and both falls at home and sports in the oldest age group (13-18 years). The little finger ray are the most frequently injured part of the hand followed by the middle finger. CONCLUSION Our series showed that most hand fractures in children occurred at home, which requires reevaluation of home settings. Implementation of safety measures during sports activities are relevant in the oldest age group.
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Affiliation(s)
- Fahd S Al-Jasser
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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68
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Jover-Sáenz A, Barcenilla-Gaite F, López-Salcedo R, Castellana-Perelló D. [Spontaneous flash fires during use of alcohol-based hand rubs]. Enferm Infecc Microbiol Clin 2015; 33:503. [PMID: 25769382 DOI: 10.1016/j.eimc.2015.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 02/08/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Alfredo Jover-Sáenz
- Unidad Funcional para el control de la Infección Nosocomial (UFIN), Hospital Universitari Arnau de Vilanova, Lleida, España.
| | - Fernando Barcenilla-Gaite
- Unidad Funcional para el control de la Infección Nosocomial (UFIN), Hospital Universitari Arnau de Vilanova, Lleida, España
| | - Rosamary López-Salcedo
- Unidad Funcional para el control de la Infección Nosocomial (UFIN), Hospital Universitari Arnau de Vilanova, Lleida, España
| | - Dolors Castellana-Perelló
- Unidad Funcional para el control de la Infección Nosocomial (UFIN), Hospital Universitari Arnau de Vilanova, Lleida, España
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Abstract
UNLABELLED Cutting scissors are important working tools for Nigerian custom tailors (CTs) but its usage apparently does not meet the ergonomics need of these artisans. A survey was carried out amongst CTs using questionnaires to obtain their background social-occupational demographics and observation methods to study their work performance, use of scissors and any cumulative trauma disorder (CTD) in their hands. Thicknesses of various fabrics were measured and comparison between Western world's custom tailoring job and the Nigerian type was done. The results showed some CTD risk factors with finger contusions on the 71 CTs evaluated. The right-hand contusions were traced to the constant usage of unpadded manual scissors with ungloved hands. Disparity between Western and Nigerian tailoring practice may account for the high occurrence of disorders in Nigerian CTs. Since hand dimensions are crucial in the design of hand tools, it is therefore concluded that hand anthropometry of Nigerian CTs and soft padding of manual scissors may mitigate CTD burdens on CTs' hands. PRACTITIONER SUMMARY Cumulative trauma disorders on the hands of low-income Nigerian CTs needed investigation. This was done via self-assessment and observational methods of the artisans’ work system. Frequent usage of unpadded manual scissors with un-gloved hands cause and exacerbate the problem. Hand anthropometry of users is crucial in scissors manufacturing.
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Affiliation(s)
- Asif M Ilyas
- Rothman Institute, Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA.
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72
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Keles MK, Aykan A, Yapici AK. Can an innocent toy become dangerous? The hydrogen gas balloon burn. Burns 2014; 41:415. [PMID: 25468479 DOI: 10.1016/j.burns.2014.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/14/2014] [Indexed: 11/16/2022]
Affiliation(s)
- Musa Kemal Keles
- Department of Plastic and Reconstructive Surgery, Burn Center, Gulhane Military Medical Academy, Ankara, Turkey
| | - Andac Aykan
- Department of Plastic and Reconstructive Surgery, Burn Center, Gulhane Military Medical Academy, Ankara, Turkey.
| | - Abdul Kerim Yapici
- Department of Plastic and Reconstructive Surgery, Burn Center, Gulhane Military Medical Academy, Ankara, Turkey
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73
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Bowen WT, Slaven EM. Evidence-Based Management Of Acute Hand Injuries In The Emergency Department. Emerg Med Pract 2014; 16:1-27. [PMID: 26371445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 09/10/2014] [Indexed: 06/05/2023]
Abstract
Although injuries of the hand are infrequently life-threatening, they are common in the emergency department and are associated with significant patient morbidity and medicolegal risk for physicians. Care of patients with acute hand injury begins with a focused history and physical examination. In most clinical scenarios, a diagnosis is achieved clinically or with plain radiographs. While most patients require straightforward treatment, the emergency clinician must rapidly identify limb-threatening injuries, obtain critical clinical information, navigate diagnostic uncertainty, and facilitate specialist consultation, when required. This review discusses the clinical evaluation and management of high-morbidity hand injuries in the context of the current evidence.
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Affiliation(s)
- W Talbot Bowen
- Section of Emergency Medicine, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Ellen M Slaven
- Clinical Associate Professor of Medicine, Section of Emergency Medicine, Louisiana State University Health Sciences Center, New Orleans, LA
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74
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Nazarov IV, Tolmachev IA, Bozhchenko AP. [The establishment of the fact of the application of an electric circular saw with the high-speed reciprocating motion of the blade]. Sud Med Ekspert 2014; 57:32-34. [PMID: 25764881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper reports a case of forensic medical expertise of an unintentional (accidental) injury inflicted by an electric circular saw with the high-speed reciprocating motion of the blade (jigsaw) under conditions of human operational activities.
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75
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Affiliation(s)
- Joe Coyle
- University of Toronto Toronto, ON, Canada
| | | | - Otto Chan
- The London Independent Hospital London, UK
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76
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Chen YB, Hao XS, Zhang B, Hao YP, Liang D. [Recurrent cold injuries of right hand as the first presentation of syringomyelia: a case report]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16:91. [PMID: 24461188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Yin-Bo Chen
- Department of Pediatric Neurology, First Hospital, Jilin University, Changchun 130021, China
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77
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Fischer LH, Abzug JM, Osterman AL, Stern PJ, Chang J. Complications of common hand and wrist surgery procedures: flexor and extensor tendon surgery. Instr Course Lect 2014; 63:97-103. [PMID: 24720297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Orthopaedic and hand surgeons frequently treat disorders of the flexor and extensor tendon systems. Common conditions, such as trigger finger, de Quervain tenosynovitis, extensor tendon injury, and zone II flexor tendon injury, can be challenging to treat. Complications that limit normal hand function still occur despite advances in surgical techniques and therapy protocols. It is helpful to be aware of the complications related to the treatment of these hand disorders and understand surgical techniques to minimize their frequency.
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Affiliation(s)
- Lauren H Fischer
- Resident, Department of Plastic Surgery, Stanford University Medical Center, Palo Alto, California
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78
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van der Zee C, Smeulders M, van de Kar A. [Hand injuries caused by fireworks and treated by plastic surgeons]. Ned Tijdschr Geneeskd 2014; 158:A8381. [PMID: 25467025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To make an inventory of the number and nature of hand injuries caused by private firework use in the Netherlands during the New Year celebrations 2013-2014 and that were seen and treated by plastic surgeons. DESIGN Descriptive study. METHOD In October 2013 the Netherlands Association of Plastic Surgeons (Nederlandse Vereniging voor Plastische Chirurgie) asked its members to register patients treated for hand injuries caused by fireworks during the New Year celebrations 2013-2014. The registration form was sent to all members by email. Patient data, the sort of firework, the nature of and treatment for the injury and the legality of the fireworks were registered. It was also important to note which hand was affected, whether it was the dominant hand and how many fingers were involved. Finger, thumb and hand amputations were also recorded. RESULTS A total of 76 patients were seen by a plastic surgeon for the treatment of hand injuries caused by fireworks. The patients were all male. In 50% of patients the injury was caused by setting off illegal fireworks. The largest group of victims were aged < 18 years. In 7 patients the hand was amputated to the level of the radiocarpal joint. A total of 232 fingers were injured by fireworks, leading to 63 total finger amputations, including 11 total thumb amputations. Many serious injuries occurred outside the legally permitted time period for setting off fireworks. CONCLUSION The number of victims with serious hand injuries caused by fireworks was high during the New Year celebrations 2013-2014 and had increased in comparison with the preceding year. The majority of victims were aged < 18 years and were injured while setting off illegal fireworks by themselves.
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79
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Niu R, Woodbridge AB, Smith BJ, Ruff SJ, Lawson RD. Mobile garbage bins and hand injuries in older people. Med J Aust 2013; 199:491-2. [PMID: 24099211 DOI: 10.5694/mja13.10212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 07/03/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To conduct a database search, chart and literature review of open extensor tendon and proximal interphalangeal joint injuries incurred while handling mobile garbage bins. DESIGN, SETTING AND PARTICIPANTS A review of medical records at a Sydney tertiary referral hospital and a NSW rural Level 2 trauma hospital from 1 January 2006 to 31 December 2010, identified through database searches of appropriate medical record codes and followed by a chart review. RESULTS We identified 11 patients with finger injuries from handling mobile garbage bins that necessitated hospital-based treatments. Their average age was 75 years. Eight patients required surgery. Patients typically fell while maintaining their grip on mobile garbage bin handles, causing abrasive injury to the dorsal aspect of the proximal interphalangeal joint. CONCLUSIONS Older patients are at risk of significant injuries to the dorsal side of their fingers when manoeuvring mobile garbage bins. This risk could be reduced by providing older members of the community with help to move their bins, or by modifying the design of bin handles. We propose a simple modification to the design of bin handles.
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80
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Fantus RJ. NTDB data points: Keep your hands and fingers off the table. Bull Am Coll Surg 2013; 98:66-67. [PMID: 23691685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Schulz MR, Grzywacz JG, Chen H, Mora DC, Arcury TA, Marín AJ, Mirabelli MC, Quandt SA. Upper body musculoskeletal symptoms of Latino poultry processing workers and a comparison group of Latino manual workers. Am J Ind Med 2013; 56:197-205. [PMID: 22847516 DOI: 10.1002/ajim.22100] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2012] [Indexed: 01/27/2023]
Abstract
BACKGROUND Upper body musculoskeletal injuries are often attributed to rapid work pace and repetitive motions. These job features are common in poultry processing, an industry that relies on Latino immigrants. Few studies document the symptom burden of immigrant Latinos employed in poultry processing or other manual jobs. METHODS Latino poultry processing workers (n = 403) and a comparison population of 339 Latino manual workers reported symptoms for six upper body sites during interviews. We tabulated symptoms and explored factors associated with symptom counts. RESULTS Back symptoms and wrist/hand symptoms lasting more than 1-day were reported by over 35% of workers. Poultry processing workers reported more symptoms than comparison workers, especially wrist and elbow symptoms. The number of sites at which workers reported symptoms was elevated for overtime workers and workers who spoke an indigenous language during childhood. CONCLUSION Workplace conditions facing poultry processing and indigenous language speaking workers deserve further exploration.
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Affiliation(s)
- Mark R Schulz
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina 27402-6170, USA.
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82
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Smeulders MJC, Gorter RR, Cense HA, van Trier AT. [Unexpected abdominal trauma from a fireworks explosion]. Ned Tijdschr Geneeskd 2013; 157:A6827. [PMID: 24299629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Fireworks injuries are common and often affect children. Such injuries should be considered high energy trauma in the emergency room and taken care of according to the principles of the Advanced Trauma Life Support (ATLS). CASE DESCRIPTION A 7-year-old boy was a victim of an explosion when he set off illegal fireworks. During evaluation in the emergency department he presented with a superficial laceration on the belly and extensive hand injury. Upon examination he had small-intestinal perforation that required immediate resection. The patient recovered well, but suffered permanent damage to the hand. CONCLUSION Potentially life threatening injuries may accompany hand injuries after modern illegal fireworks. Hand injuries are serious. Despite prolonged treatment, they often result in permanent disability. The structured approach to trauma according to ATLS was important in detecting an accompanying abdominal trauma in this case.
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Affiliation(s)
- Mark J C Smeulders
- Academisch Medisch Centrum, afd. Plastische, reconstructieve en handchirurgie, Amsterdam
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83
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Meester RJ, Ritt MWJ, Bloemers FW. [A man with acute, painless swelling of the hand]. Ned Tijdschr Geneeskd 2013; 157:A6810. [PMID: 24252408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 48-year-old man visited the hand surgery outpatient clinic with acute, painless swelling of the dorsal side of the right hand and fingers. We found erythema and crepitations of the skin. Laboratory tests showed no signs of infection. After X-ray and echography of the hand we made the diagnosis subcutaneous emphysema. It was caused by a microtrauma with high pressure air.
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Affiliation(s)
- Rinse J Meester
- VU Medisch Centrum, afd. Plastische Chirurgie & Traumachirurgie, Amsterdam
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84
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Shahzad MN, Ahmed N, Qureshi KH. Reverse flow posterior interosseous flap: experience with 53 flaps at Nishtar Hospital, Multan. J PAK MED ASSOC 2012; 62:950-954. [PMID: 23139982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To assess the efficacy of reverse flow posterior interosseous artery flap for the coverage of large variety of hand/wrist defects. METHODS The prospective study was conducted a the Department of Plastic Surgery and the Burns Unit of Nishtar Hospital, Multan, Pakistan, from June 2008 to June 2010. The study comprised 53 reverse flow posterior interosseous artery flaps in 50 patients for the coverage of hand/wrist defects both in emergency and elective settings. Data was analysed using SPSS 10. RESULTS The hand/wrist defects in the study population were caused by different etiologies. All the flaps survived in all the patients. Marginal loss over the distal edge of the flap was noted in one patient. Mild oedema developed in all patients, but it subsided except in one case. None of our cases showed any evidence of venous congestion. Regarding the donor site morbidity, only one case had partial STSG loss. Mean hospital stay post-flap coverage in the patients ranged from 7 to 21 days. CONCLUSION Reverse flow posterior interosseous artery flap in experienced hands is safe, versatile and reliable for the coverage of hand/wrist defects.
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85
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Iyengar KP, Nadkarni JB, Gupta R, Beeching NJ, Ullah I, Loh WY. Mycobacterium chelonae hand infection following ferret bite. Infection 2012; 41:237-41. [PMID: 22930069 DOI: 10.1007/s15010-012-0309-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 07/13/2012] [Indexed: 11/25/2022]
Abstract
We present a case of hand infection caused by Mycobacterium chelonae. The patient was a 58-year-old woman with Type II diabetes mellitus and stage 4 chronic kidney disease. The infection occurred following a ferret bite and had not responded to oral antibiotics in the primary care setting. She developed signs of pyogenic flexor tenosynovitis of the index and middle fingers of her left hand. Laboratory parameters showed high C-reactive protein, raised erythrocyte sedimentation rate and leucocytosis. Ultrasound imaging confirmed the clinical diagnosis. Plain radiographs showed no osseous involvement. The infection was treated with surgical debridement and broad spectrum parenteral antibiotics. The intra-operative tissue specimens were initially negative on aerobic and anaerobic cultures. Following transient improvement of her inflammatory parameters and clinical signs, she developed a recurrence with added features of osteomyelitis of the index and middle finger metacarpal heads on repeat radiographs. A revision surgical debridement of the flexor tenosynovitis and osteomyelitis with specific long-term antibiotic cover has led to resolution of the infection. Extended cultures of the tissue specimens at the regional laboratory confirmed the causative organism to be M. chelonae. To our knowledge, this is the first reported case of M. chelonae infection resulting from a ferret bite. This case reminds us of the need for a high index of suspicion for infection with uncommon pathogens following animal bites, especially in patients with altered immune status.
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Affiliation(s)
- K P Iyengar
- Department of Trauma and Orthopaedics, Southport and Ormskirk Hospital NHS Trust, Town Lane, Kew, Southport, PR8 6PN, UK.
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DavasAksan A, Durusoy R, Bal E, Kayalar M, Ada S, Tanik FA. Risk factors for occupational hand injuries: relationship between agency and finger. Am J Ind Med 2012; 55:465-73. [PMID: 22334304 DOI: 10.1002/ajim.22016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this study was to define the risk factors for occupational hand injuries and explore the relationship between the machines and the fingers injured, based on the records of a hospital in Turkey specialized in hand and microsurgery. METHODS Five thousand twenty seven occupational hand injuries treated at a hand and microsurgery hospital between 1992 and 2005 were included in the study. All the injuries were retrospectively recoded according to ICD-10, (ICECI) and ILO recommendations. Logistic regression and chi-square for trend analysis were used to evaluate the risk factors for occupational injuries. RESULTS The most frequent injuries were traumatic amputation of wrist and hand (53.2%), open wound of wrist and hand (46.3%). Considering all injuries, 60.9% of agricultural machines, 52.7% of metal working machines, 54.7% of transmission machinery, and 42.8% of wood and assimilated machines affected the right hand. Powered wood cutters, presses, planning and milling machines, and machine belts were the most frequent five machines involved in injuries, each having a different finger pattern. The proportion of machinery among all hand injuries was significantly decreasing with time. CONCLUSION A stricter and more frequent supervision of the use of protective equipment and prohibition of the purchase of machinery not complying with the regulations could contribute to the prevention of hand injuries.
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Affiliation(s)
- Asli DavasAksan
- Department of Public Health, Ege University Medical School, Bornova, Izmir, Turkey.
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87
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Garg R, Cheung JPY, Fung BKK, Ip WY. Epidemiology of occupational hand injury in Hong Kong. Hong Kong Med J 2012; 18:131-136. [PMID: 22477736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES To study the epidemiology of occupational hand injuries and associated social and industrial factors. DESIGN. For this retrospective case series of patients with occupational hand injuries, case records were retrieved to gather data. In addition, all the subjects were interviewed by a single interviewer using a predesigned questionnaire. SETTING Division of Hand Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong. PATIENTS A total of 250 patients with occupational hand injuries were treated during the period from 1999 to 2001. This period was chosen to obtain 10 years of follow-up data to assess return to work and any secondary injuries. MAIN OUTCOME MEASURES Personal particulars (gender, age, marital status, education level, length of stay in Hong Kong, type of employment, wage system, personal habits, family size, number of breadwinners, income), type of industry and mode of injury, causes of injury according to the worker, work conditions, type of injury, and treatment given. RESULTS Two groups of workers in our study had more occupational hand injuries, namely those with less than 1 year of experience on a new job and immigrants from China. Factors associated with a large proportion of occupational hand injuries were male gender with personal risk factors (smoking and regular consumption of alcohol, long working hours), and in the case of machine operators, inadequate training and use of safety devices. CONCLUSION Occupational hand injuries lead to loss of working hours and compensation. For prevention, the workplace should be made into a safer and work-friendly environment. Workers should also have sufficient training.
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Affiliation(s)
- Rajesh Garg
- Department of Orthopaedics and Traumatology, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong
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88
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Sozaonti ZR, Nizovtsova LA, Ridén TV. [Radiation studies in blast mine injuries to the torso and limbs]. Vestn Rentgenol Radiol 2011:48-56. [PMID: 22420212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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89
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Huysmans MA, Ijmker S, Blatter BM, Knol DL, van Mechelen W, Bongers PM, van der Beek AJ. The relative contribution of work exposure, leisure time exposure, and individual characteristics in the onset of arm–wrist–hand and neck–shoulder symptoms among office workers. Int Arch Occup Environ Health 2011; 85:651-66. [PMID: 22038090 DOI: 10.1007/s00420-011-0717-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 10/11/2011] [Indexed: 11/30/2022]
Affiliation(s)
- Maaike A Huysmans
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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90
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Cheah AEJ, Chong AKS. Bites to the hand: are they more than we can chew? Singapore Med J 2011; 52:715-719. [PMID: 22009389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Animal bites to the hand caused by dogs, cats and humans are common conditions that general practitioners, emergency physicians and hand surgeons encounter in their practice. These bites are prone to infection and represent great cost to the patient in terms of time, money and disability, if not treated optimally from the outset. Other than lacerations to the skin, injuries to the tendons, nerves, bone and joints are commonplace given their proximity to the skin surface in the hand. Optimal treatment of acute animal bites to the hand should include clearance of contamination by surgical debridement, prophylactic antibiotics and tetanus toxoid, as well as staged reconstruction of all damaged tissue, including the skin, once the wound is deemed clean.
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Affiliation(s)
- A E J Cheah
- Department of Hand and Reconstructive Microsurgery, National University Hospital, National University Health System, 1E Kent Ridge Road, Singapore 119228.
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91
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Olaitan PB, Ubah JN. Accidental tear gas injuries in security agents. Niger J Med 2011; 20:275-278. [PMID: 21970243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Tear gas is a noxious vapour used in quelling civil disturbances. The law enforcement agents who usually handle this are well trained and rarely injured by the use of this weapon especially during peace times. METHODS We report injuries sustained by two policemen handling tear gas as a result of accidents. Case notes of the patients were the source of information. RESULTS Two policemen were injured while handling tear gas. The equipment accidentally dropped and exploded on attempting to pick them. The mechanisms of injuries and parts of the body injured were similar ie the hands and face with traumatic cataract of an eye in one patient. CONCLUSION We conclude that proper training of the law enforcement agents will go a long way in reducing these types of morbidity from tear gas use.
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Affiliation(s)
- P B Olaitan
- Department of Surgery, LAUTECH Teaching Hospital, Osogbo, Osun state, Nigeria.
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92
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Guiavarch M, Médus M, Tichadou L, Glaizal M, de Haro L. [Uneven efficacy of Viperfav® antivenom for the treatment of neurotoxic viper envenomations]. Presse Med 2011; 40:654-6. [PMID: 21397446 DOI: 10.1016/j.lpm.2011.01.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 01/18/2011] [Accepted: 01/23/2011] [Indexed: 11/19/2022] Open
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Abstract
Capnocytophaga canimorsus infection is the most severe and rapidly progressive bacterial infection transmitted by dog bite and fortunately is very rare. The authors describe a 68-year-old gentleman who presented in an acute confusional state 2 days after having been bitten on the left hand by a dog. Despite immediate broad-spectrum intravenous antibiotics, he developed significant sequelae including disseminated intravascular coagulopathy, microvascular emboli leading to peripheral necrosis, widespread local tissue destruction and septic arthritis. Our case illustrates a life-threatening presentation of infection with C. canimorsus, which is known as 'the dog bite organism'. Early diagnosis and aggressive treatment is key to survival.
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Affiliation(s)
- Joseph Hawkins
- Department of Internal Medicine, Conquest Hospital, St Leonards-on-Sea, East Sussex, UK
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Rainer PP, Kaufmann P, Smolle-Juettner FM, Krejs GJ. Case report: Hyperbaric oxygen in the treatment of puff adder (Bitis arietans) bite. Undersea Hyperb Med 2010; 37:395-398. [PMID: 21226389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The puff adder (Bitis arietans) is a venomous viper mainly found in sub-Saharan Africa. Due to its common occurrence and potent venom, it is considered to be the most dangerous snake in Africa, responsible for most snakebite fatalities there. Puff adder bites outside Africa are rare and involve captive vipers. We present the unusual case of puff adder envenomation in an Austrian man. CASE REPORT A 26-year-old Austrian man was bitten by a puff adder that he kept illegally in his home. On admission he showed signs of local and systemic toxicity. He was stabilized with antivenom, intravenous fluids, catecholamines and packed platelets. Hyperbaric oxygenation was begun due to incipient compartment syndrome on the second day and continued until the eleventh day, when the patient had recovered completely and could be discharged. DISCUSSION The venom of Bitis arietans can cause serious systemic and local complications. Our patient suffered from both. Systemic signs included hemodynamic as well as hemostaseologic impairment. Local effects included swelling and incipient compartment syndrome. Systemic and local treatment, including hyperbaric oxygenation, effected a full recovery. We suggest that, whenever feasible, hyperbaric oxygenation should be considered as adjunct treatment in snake bites to avert adverse outcomes.
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Affiliation(s)
- Peter P Rainer
- Department of Medicine, Medical University of Graz, Austria.
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95
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Hochedez P, Thomas L, Mehdaoui H. Hyperbaric oxygen therapy after Bothrops lanceolatus snake bites in Martinique: a brief report. Undersea Hyperb Med 2010; 37:399-403. [PMID: 21226390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Every year 10 to 20 cases of snake bites are reported on the Caribbean island of Martinique. The only snake involved, Bothrops lanceolatus, is endemic on the island, and its bite may lead to systemic multifocal thrombotic complications in the'absence of the monospecific antivenom. Between January 1988 and January 2009, more than 250 snake bites have been reported, and five patients were treated with hyperbaric oxygen (HBO2) therapy for local complications. The patients were male, bitten on the leg or the hand, and presented with severe complications such as necrotizing soft tissue infections, compartment syndrome or abscesses despite prompt wound care and administration of antivenomous serum. Outcomes were favorable for these five patients, except for one who was left with a functional defect of the hand. Although snake bites are not part of the currently recommended indications for HBO2 therapy, local complications, namely compartment syndrome, necrotizing soft tissue infections and enhancement of healing in selected problem wounds, are approved uses of HBO2 therapy as defined by the Hyperbaric Oxygen Therapy Committee and would benefit from prospective studies.
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Affiliation(s)
- P Hochedez
- Infectious Disease Department, Teaching Hospital, Fort de France, Martinique, France.
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96
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Namdar T, Namdar S, Mailänder P. [Minor injuries of the hand. Small cause--serious consequences]. MMW Fortschr Med 2010; 152:34. [PMID: 21053510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Thomas Namdar
- Intensiveinheit für Schwerbrandverletzte, Universitätsklinikum Schleswig-Holstein Campus Lübeck
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97
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Namdar T, Stollwerck PL, Stang FH, Senyaman O, Siemers F, Mailänder P, Lange T. [Bite injury of the hand]. MMW Fortschr Med 2010; 152:37-38. [PMID: 21053512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Thomas Namdar
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
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Xu GG, Yam A, Teoh LC, Yong FC, Tay SC. Epidemiology and management of surgical upper limb infections in patients with end-stage renal failure. Ann Acad Med Singap 2010; 39:670-675. [PMID: 20957300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Hand infections in patients with end-stage renal failure (ESRF) are more diffi cult to treat and have had the worse outcomes. This paper examines the epidemiology, bacteriology and outcomes of surgically managed upper limb infections in these vulnerable patients. MATERIALS AND METHODS All patients from a single centre with surgically-managed upper limb infections between 2001 and 2007 were reviewed. We collected epidemiological data on demographics, type and site of infection, bacteriology, surgical treatment, complications and mortality. RESULTS Forty-seven out of 803 (6%) patients with surgically managed upper limb infections in the study period had ESRF. The average age was 59 years. ESRF was secondary to diabetes in 88% of cases. Patients presented on average 7 days after onset of symptoms. Abscesses (34%), wet gangrene (26%) and osteomyelitis (11%) were the commonest infections. Methicillin-resistant Staphylococcus aureus (MRSA) was the commonest pathogen (29%), occurring either in isolation or with other organisms. Eighteen percent of single organisms cultured were gram-negative. Multiple organisms occurred in 29%. A median of 2 operations were required. Thirty-six percent of all cases required amputation. Twenty-fi ve percent of patients had a life-threatening event (myocardial infarction or septic shock) during treatment. CONCLUSIONS ESRF patients present late with severe upper limb infections. Nosocomial infections are common. Initial empirical antibiotic treatment should cover MRSA and gram-negative bacteria. Immediate referral to a hand surgery unit is recommended. Multi-disciplinary management of the patient with input from physicians and anaesthetists or intensivists in the perioperative period is necessary to optimise the patient for surgery and to manage active medical comorbidities and complications after surgery.
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Affiliation(s)
- Germaine G Xu
- Department of General Surgery, Tan Tock Seng Hospital, Singapore
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Güven E, Uğurlu AM, Hocaoğlu E, Kuvat SV, Elbey H. Treatment of post-burn upper extremity, neck and facial contractures: report of 77 cases. ULUS TRAVMA ACIL CER 2010; 16:401-406. [PMID: 21038116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Post-burn contractures severely deteriorate life quality. We aimed to present our treatment protocols for post-burn sequelae and the contractures that cause functional limitations. METHODS Seventy-seven cases with post-burn contracture were treated in our clinic. Post-burn contractures occurring after a burn injury affected the upper extremity, face and neck in 60, 17 and 6 cases, respectively. Skin grafts, local flaps such as advancement flaps, Z-plasties, K-plasties, regional flaps such as posterior interosseous flap, tissue expanded flaps, and free flaps were used according to the severity of the contractures. RESULTS In one patient with type II axillary contraction, recurrence was seen. Full range of motion was achieved in the 3.6-year follow-up period in elbow contractures. Eight of 71 phalangeal joint contractures recurred. Two patients underwent reoperation for neck contracture recurrences. CONCLUSION Excellent results were seen with prefabricated flaps, which were used for the facial reconstruction.
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Affiliation(s)
- Erdem Güven
- Department of Plastic, Reconstructive and Aesthetic Surgery, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
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Frank M, Ekkernkamp A. Small change, big impact: prevention of vole captive bolt device hand injuries. J Trauma 2010; 69:478. [PMID: 20699764 DOI: 10.1097/ta.0b013e3181e5dc68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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