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Nyszkiewicz RD, Baur EM, van Schoonhoven J, Goehtz F, Tenbrock A, Lutz T, Millrose M, Becker K, Engelhardt TO, Haas-Lützenberger EM, Haerle M, Hakimi M, Lautenbach M, Mühldorfer-Fodor M, Weihs N, Zach A, Scale A. [The complexity of hand-surgical procedures in the context of cross-sector care concepts: a consensus recommendation of the German Society of Hand Surgery]. HANDCHIR MIKROCHIR P 2023; 55:216-222. [PMID: 37307812 DOI: 10.1055/a-2067-4727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Overboarding politcal influence in Germany concerning medical issues has come to a new peak. The report by the IGES Institute published in 2022 made an important contribution in this regard. Unfortunately, only that part of the recommendations of this report were implemented in a new version of the contract for outpatient surgery according to Section 115b SGB V (AOP contract), that called for an expansion of outpatient surgery. In particular, those aspects that are important from a medical point of view for a patient-specific adjustment of outpatient surgery (e. g. old age, frailty, comorbidities) as well as the important structural requirements for outpatient postoperative care were included in the new AOP contract at best in a rudimentary manner. For this reason, the German Society for Hand Surgery felt compelled to give its members a recommendation as to which medical aspects must be taken into account, especially when performing hand surgery operations, in order to ensure the highest level of safety for the patients entrusted to us while performing outpatient surgery. An expert group of experienced hand surgeons and hand therapists who work in hospitals of all levels of care as well as resident surgeons was formed in order to formulate mutually agreed recommendations for action.
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Affiliation(s)
- Ralf Dietger Nyszkiewicz
- Klinik für Orthopädie, Unfall- und Handchirurgie, GLG Werner Forßmann Klinikum Eberswalde, Eberswalde, Germany
| | - Eva-Maria Baur
- Praxis für Plastische Chirurgie und Handchirurgie Dr. med. Eva Baur, Murnau, Germany
| | - Jörg van Schoonhoven
- Klinik für Handchirurgie, Rhön Klinikum Campus Bad Neustadt, Bad Neustadt, Germany
| | - Florian Goehtz
- Klinik für Handchirurgie, Rhön Klinikum Campus Bad Neustadt, Bad Neustadt, Germany
| | - Arne Tenbrock
- Abteilung Handchirurgie, obere Extremität und Fußchirurgie, Zentrum für Orthopädie und Unfallchirurgie, Rheumaorthopädie, Krankenhaus Waldfriede Berlin, Berlin, Germany
| | - Tobias Lutz
- Klinik für Plastische und Ästhetische Chirurgie, Sana Kliniken Lübeck GmbH, Lübeck, Germany
| | - Michael Millrose
- Abteilung für Unfallchirurgie, Sportorthopädie, Kindertraumatologie und Handchirurgie, Klinikum Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
- Klinik für Orthopädie und Unfallchirurgie, Paracelsus Medizinische Privatuniversität - Nürnberg, Nürnberg, Germany
| | - Karsten Becker
- Handchirurgisches Zentrum Dr. Karsten Becker, Hannover, Germany
| | - Timm Oliver Engelhardt
- Plastische Chirurgie & Handchirurgie Ebersberg, Kreisklinik Ebersberg gemeinnützige GmbH Pfarrer-Guggetzer, Germany
| | | | - Max Haerle
- Klinik für Hand- und Plastische Chirurgie, Orthopädische Klinik Markgröningen gGmbH, Markgröningen, Germany
| | - Mohssem Hakimi
- Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Vivantes Klinikum, Berlin, Germany
| | - Martin Lautenbach
- Abteilung Handchirurgie, obere Extremität und Fußchirurgie, Zentrum für Orthopädie und Unfallchirurgie, Rheumaorthopädie, Krankenhaus Waldfriede Berlin, Berlin, Germany
| | | | - Natascha Weihs
- Klinik für Handchirurgie, Rhön Klinikum Campus Bad Neustadt, Bad Neustadt, Germany
| | - Alexander Zach
- Praxis für Orthopädie, Unfall- und Handchirurgie Dr. Zach, Greifswald, Germany
| | - Adrian Scale
- Fachbereich Hand- und Replantationschirurgie, BG Unfallkrankenhaus Berlin, Berlin, Germany
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Mohamad Sabri MQ, Judd J, Ahmad Roslan NF, Che Daud AZ. Hand characteristics and functional abilities in predicting return to work in adult workers with traumatic hand injury. Work 2022; 73:1245-1253. [DOI: 10.3233/wor-205164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Hand injuries affect a person’s functioning, thus impeding their abilities to return to work. There is a limited understanding in return to work of the overall predictors when including hand characteristics and functional abilities. Therefore, it is essential to identify the most relevant predictors in return to work among individuals with a hand injury. OBJECTIVES: (1) To compare hand function characteristics and functional abilities of injured workers who have or have not returned to work. (2) To estimate hand function characteristics and functional abilities as predictors to return to work. METHODS: One hundred and fifteen adult workers with hand injuries aged 18– 59 years old from five general hospitals in Malaysia participated in a cross-sectional study. Predictors were estimated using logistic regression. RESULTS: There was a significant association between occupational sector (p = 0.012), injury duration (p = 0.024), occupational performance (p = 0.009) and satisfaction with performance (p < 0.001), grip strength of injured hand (p = 0.045– 0.002) and the Disability of Arm, Shoulder and Hand (DASH) disability/symptom (p = 0.001) with the person’s return to work status. Significant predictors of return to work were identified using the Canadian Occupational Performance Measure (COPM) satisfaction’s score, DASH disability/symptoms’ score and duration of the injury. CONCLUSION: As two main predictors of return to work were COPM satisfaction and DASH disability/symptoms, occupational therapists working in rehabilitation should focus on achieving functional performance and satisfaction within the optimal time.
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Affiliation(s)
- Mohamad Qayum Mohamad Sabri
- Centre of Occupational Therapy, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), UiTM Kampus Puncak Alam, Bandar Puncak Alam, Selangor, Malaysia
| | - Jenni Judd
- School of Health Medical and Applied Sciences, Division of Higher Education, Centre for Indigenous Health Equity Research, Central Queensland University, Bundaberg Campus, Branyan, QLD, Australia
| | - Nor Faridah Ahmad Roslan
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Kampus Sungai Buloh, Sungai Buloh, Selangor, Malaysia
| | - Ahmad Zamir Che Daud
- Centre of Occupational Therapy, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), UiTM Kampus Puncak Alam, Bandar Puncak Alam, Selangor, Malaysia
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Fontaine C. A special issue for the editor-in-chief. HAND SURGERY & REHABILITATION 2021; 39:471-473. [PMID: 33158478 DOI: 10.1016/j.hansur.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Fontaine
- Henri Warembourg faculty of medicine, institute of anatomy, university of Lille, place de Verdun, 59045 Lille cedex, France.
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Millrose M, Kim S, Eichenauer F, Gesslein M, Eisenschenk A, Asmus A. [Input of the start on the result of a special interdisciplinary rehabilitation program for work-related injuries of the hand]. HANDCHIR MIKROCHIR P 2021; 53:61-66. [PMID: 33588491 DOI: 10.1055/a-1344-8928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The objective of this study was to evaluate the outcome of a special interdisciplinary hand therapy program depending on the time interval between trauma and rehabilitation. PATIENTS AND METHODS With use of self-assessed scores (Disability of the Arm, Shoulder and Hand Score [DASH-Score], European Quality of Life 5 Dimensions [EQ-5D]) and objective functional parameters (TAM = Total Active Motion for finger injuries, ROM = Range of Motion for wrist injuries, grip strength) the outcome of 76 patients with injuries of the fingers, wrist or a complex regional pain syndrome (CRPS) was analysed at the begin and end of an inpatient rehabilitation and at a follow-up examination after 12 to 16 weeks. The patients were divided into groups with an early (< 120 days after trauma) or late beginning of their rehabilitation. RESULTS At the follow-up examination early beginners had a significant better DASH-Score as well as a ROM. At the end of the rehabilitation program and at the time of the follow-up examination significant more patients with an early as patients with a late start of the rehabilitation were back to work. Especially patients with CRPS and finger injuries benefit from an early start of the rehabilitation. CONCLUSION Compared to a late start an early start of a rehabilitation program after finger and hand injuries and a CRPS leads to better functional with special benefit for patients with a CRPS.
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Affiliation(s)
- Michael Millrose
- BG Unfallklinik Murnau Abteilung für Unfallchirurgie und Sporttraumatologie
| | - Simon Kim
- Ernst-Moritz-Arndt Universitat Greifswald Klinik und Poliklinik für Unfall-, Wiederherstellungschirurgie und Rehabilitative Medizin
| | - Frank Eichenauer
- Unfallkrankenhaus Berlin Abteilung für Hand-, Replantations- und Mikrochirurgie
| | - Markus Gesslein
- Paracelsus Medizinische Privatuniversitat - Nürnberg Klinik für Orthopädie und Unfallchirurgie
| | - Andreas Eisenschenk
- Unfallkrankenhaus Berlin Abteilung für Hand-, Replantations- und Mikrochirurgie
| | - Ariane Asmus
- Unfallkrankenhaus Berlin Abteilung für Hand-, Replantations- und Mikrochirurgie
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