The Management Outcome of Acute Hand Injury in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia

Background: Hand is the most commonly injured part of our body. The aim of treatment islways to restore its movement; strength and dexterity. The quality of primary treatment often determines the maximal potential for recovery. The objective of this study was to evaluate the management outcome and consequences of the injured hand. Methods: Between 1st January 2005 and 31st December 2005; a total of 253 patients were treated in Tikur Anbessa University Hospital for acute hand injury that presented within the first 24 hours of the occurrence. We evaluate the mechanism of injury; types and duration of treatments and complications. Results: The mean age was 32 years and the male to female ratio was 7:1. The majority of patients were wood worker (32) followed by laborers (25) and machine operators (15).Three quarter of the injuries occurred at work; of which 74were caused by machines. The commonest injuries included fracture in 39of which the majority (85)mwere compound;amputation in 31and soft tissue injury in 26. The injury severity was moderate and above in 54. Most were managed at emergency out-patient department and the average total treatment time was 93 days. The average impairment of hand function before and after treatment was 6and 19respectively. The main reason for more loss of function after treatment were more proximal corrective amputation (31); prolonged immobilization (28)in nonfunctional position (17)); healed in unacceptable position (19) and infection (13).Final results were poor in 62; this was not significantly associated with severity of the injury.Conclusion: Improving treatment of injured hand and establishing specialized center for hand injury may shorten duration of treatment and improve result

Paediatric Hand Injuries at the Lagos University Teaching Hospital

Background: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carried out. Objectives: To determine the percentage of hand trauma occurring in the paediatric age group; the predominant age group involved; place of injury; the major injury types occurring as well as the most common surgical procedure required. Methods: The case records of all cases that presented at the hand rehabilitation clinic or the emergency center of the Lagos University teaching hospital over a 4 year period were reviewed. Those below the age of 12 years were studied. Their biodata; type of injury; place of injury and other details were obtained. Results: 634 patients were seen over the study period; 61 cases of hand injuries were in the paediatric age group. Hand trauma constituted less than a third of all paediatric hand cases. The commonest age group affected was 2-6 years. Most of the injuries occurred around the home. Burns injury; blunt trauma; glass and knife cuts were the commonest causes of hand trauma. Soft tissue reconstruction was commonest procedure done. Conclusion: Infants and toddlers were the most vunerable groups while burns injury was the commonest cause of hand trauma seen at the Lagos university teaching hospital