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Results of the Treatment of Major, Complex Hand Injuries

100%
Żyluk A., Janowski P.
Polish Journal of Surgery
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2011
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vol. 83
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issue 2
87-94
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.
2
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On the use of IT investment assessment methods in the area of spatial data infrastructure

88%
Zwirowicz-Rutkowska A.
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issue 1
3
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Chemical protection of winter triticale against diseases and pests and economic effectiveness of respective treatments

75%
Kaniuczak Z.
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2007
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vol. 47
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issue 1
4
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Management patterns of thrombosis prophylaxis and related costs in hip and knee replacement in Germany

75%
McBride D., Brüggenjürgen B., Roll S., Quante M., Willich S.
Open Medicine
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2007
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vol. 2
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issue 1
47-65
EN
The objective of the study was to depict treatment strategies, health care utilisation and cost evaluation of hip and knee replacement surgery in Germany, with a particular emphasis on thrombosis prophylaxis (TP) for the prevention of deep vein thrombosis (DVT). In this multi-centre prospective cohort study, medical record data (socio-demographics, risk factors for thrombosis, thrombosis prophylaxis, course of hospital stay) were collected for patients undergoing either total hip replacement (THR) or total knee replacement (TKR). One and three months post-operatively, post-operative outcomes and health care resource use were documented by patient and physician questionnaires. A total of 309 patients participated in the study (59% female, mean age 66 [SD 10] years). Parenteral anticoagulation was administered for a mean of 38 (SD 16) days. 27 (9%) patients received subsequent oral anticoagulation for a mean of 38 (SD 21) additional days. Symptomatic DVT was reported by four (1.3%) patients. Mean overall direct costs associated with surgery from baseline to 3 months were EUR 11 264 (median 11 564, SD 2 481). Hospital and rehabilitation accounted for 97% of direct costs; costs for medications, physical therapy, physician office visits, out-of-pocket expenses, as well as complication costs accounted for an additional 3% of direct costs. Within these direct costs, a mean of EUR 348 (SD 361) was related to thrombosis prophylaxis, accounting for 3% of direct costs. Mean overall cost was EUR 11 926 (SD 2 481), including 6% indirect costs of productivity loss. Extended thrombosis prophylaxis was observed in the usual care setting of the study and associated with low incidence of symptomatic DVT. Thrombosis prophylaxis is - within the considerable economic burden of joint replacement surgery - a relatively small cost component.
5
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Increasing Productivity– a Way to Improve Efficiency of Operational Management in Hard Coal Mines

75%
Prusek S., Turek M., Dubiński J., Jonek-Kowalska I.
Archives of Mining Sciences
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2018
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vol. 63
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issue 3
6
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Zanieczyszczenie powietrza w Polsce– stan, przyczyny i skutki

63%
Kuchcik M., Milewski P.
Studia KPZK
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2018
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vol. 182
7
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Koszty migracji wahadłowych ze strefy podmiejskiej do miasta rdzeniowego ośrodków wojewódzkich

63%
Lityński P., Hołuj A.
Studia KPZK
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2018
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vol. 182
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