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Number of results
2011 | 83 | 2 | 87-94

Article title

Results of the Treatment of Major, Complex Hand Injuries

Content

Title variants

Languages of publication

EN

Abstracts

EN
Complex hand injuries are associated with serious consequences including long period off-work, permanent disability, inability to return to original profession or to work at all. As these injuries are common, they create considerable economical consequences and, therefore, it is desirable their treatment would be as perfect as possible to reduce potential loss of function.The aim of the study was analysis of the structure of complex, multi-structural hand injuries and evaluation of the outcomes of the treatment of these injuries in both medical (recovery of function) and economical (period of inability to work and costs of medical care) aspects.Material and methods. The study presents the results of treatment of 78 patients suffered from severe, major hand injuries, involving damage of at least two of four anatomical structures within the hand or wrist (bones, tendons, arteries or nerves) as well as severe injury involving at least two digits. Functional results were assessed at a mean of 10 months after the accident. Tendons were repaired in all 42 patients, bones were fixed in 29 (69%), nerves were repaired in 21 (50%), arteries in 14 (33%) and in two patients skin defect was covered by the flap (one local and one groin flap).Results. Total active motion of affected digits amounted 2/3 of normative active motion of the healthy digits and total grip strength approximated half of the grip strength of the unaffected hand. In patients with nerve injuries, a satisfactory recovery of sensation in the affected digits was obtained. Dexterity of the hand in daily activity was scored 30 points in DASH scale. Injury-related duration of sick leave in 31 patients worked at the time of the accident amounted 4.4 months in average (range 1-12). A total of 27 subjects (87% of worked) returned to work: 24 to their previous profession and three had to qualify for a new job. Total hospital costs of the treatment in the analysed group amounted a mean of 2600 PLN.Conclusion. The outcomes of the treatment of major hand injuries achieved in our institution over the period of the one year were satisfactory, considering their severity and complexity. These results, in our mind, show clearly advantages coming from an existence of qualified service for hand injuries.

Keywords

EN

Publisher

Year

Volume

83

Issue

2

Pages

87-94

Physical description

Dates

published
1 - 2 - 2011
online
30 - 3 - 2011

Contributors

  • Department of General and Hand Surgery, Pomeranian Medical University in Szczecin
  • Department of General and Hand Surgery, Pomeranian Medical University in Szczecin

References

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  • Trybus M, Guzik P, Lorkowski J i wsp.: Obrażenia rąk spowodowane piłą tarczową. Przegl Lek 2008; 65: 43-46.
  • Trybus M, Lorkowski J, Hładki W i wsp.: Kalectwo pourazowe rąk. Przegl Lek 2006; 63 (supl. 5): 40-42.
  • Trybus M, Lorkowski J, Brongel L et al.: Causes and consequences of hand injuries. Am J Surg 2006; 192: 52-57.
  • Grys G, Uszyński H, Sawicki G i wsp.: Socjoekonomiczne następstwa obrażeń pourazowych ręki. Chir Narz Ruchu Ortop Pol 1998; 63: 67-71.
  • O'Sullivan ME, Colville J: The economic impact of hand injuries. J Hand Surg 1993; 18B: 395-98.
  • Hudak PL, Amadio PC, Bombardier C: Upper Extremity Collaborative Group. Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand). Am J Industr Med 1996; 29: 602-08.
  • Trybus M, Guzik P, Lorkowski J: Obrażenia rąk u osób w starszym wieku. Przegl Lek 2004; 61: 1356-59.
  • Rosberg HE, Carlsson KS, Dahlin LB: Prospective study of patients with injuries to the hand and forearm: costs, function and general health. Scand J Palst Reconstr Surg Hand Surg 2005; 39: 360-69.
  • Żyluk A, Puchalski P: Niezdolność do pracy po leczeniu zespołu nadgarstka. Chir Narz Ruchu Ortop Pol 2008;73: 303-08.
  • Weinzweig N, Chin G, Mead M et al.: "Spaghetti wrist": management and results. Plast Reconstr Surg 1998; 102: 96-102.
  • Rosberg HE, Carlsson KS, Hojgard S et al.: Injury to the human median and ulnar nerves in the forearm - analysis of costs for treatment and rehabilitation of 69 patients in southern Sweden. J Hand Surg 2005; 30B: 35-39.

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_v10035-011-0014-8
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