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

Development of Korean Academy of Medical Sciences Guideline for Rating Physical Disability of Upper Extremity

While the lower extremities support the weight and move the body, the upper extremities are essential for the activities of daily living, which require many detailed movements. Therefore, a disability of the upper extremity function should include a limitation of all motions of the joints and sensory loss, which affects the activities. In this study, disabilities of the upper extremities were evaluated according to the following conditions: 1) amputation, 2) joint contracture, 3) diseases of upper extremity, 4) weakness, 5) sensory loss of the finger tips, and 6) vascular and lymphatic diseases. The order of 1) to 6) is the order of major disability and there is no need to evaluate a lower order disability when a higher order one exists in the same joint or a part of the upper extremity. However, some disabilities can be either added or substituted when there are special contributions from multiple disabilities. An upper extremity disability should be evaluated after the completion of treatment and full adaptation when further functional changes are not expected. The dominance of the right or left hand before the disability should not be considered when there is a higher rate of disability.

Carpal boss. Tratamiento quirúrgico / Carpal boss. Surgical treatment

Carpal boss es la prominencia ósea entre segundo y tercer metacarpiano y hueso grande trapezoide, originada por un evento traumático único o repetitivo, que resulta en ruptura del ligamento interóseo dorsal entre estos huesos y que produce como consecuencia una formación ósea. Se presentan 17 casos tratados quirúrgicamente con artrodesis y fijación con 2 clavos de kirschner, obteniéndose un 100 por ciento de buenos resultados. La indicación para la cirugía fue dolor, agravado por la movilidad en extensión y la presencia de la deformidad

Clasificación de los traumatismos graves de los miembros / Classification of severe injuries of the limbs

Presentamos una clasificación de las heridas graves de los miembros dividiéndolas en cinco tipos distintos, en orden creciente de gravedad, teniendo en consideración la presencia o ausencia de fractura y/o compromiso vascular, hasta llegar a la amputación traumática. Se ejemplifica cada tipo con la presentación de un caso clínico. Creemos que la adecuada tipificación de estos pacientes es una de las bases para un correcto enfoque terapéutico, evitando los errores de tratamiento resultantes de un diagnóstico inicial inadecuado

Heridas de los miembros superiores (manos): sus causas, su diagnostico y su manejo / Upper limbs injuries (hands): their causes, diagnosis and management

Las heridas de mano tienen importantes consecuencias en la economia familiar. Este articulo analiza las diferentes causas de este tipo de trauma y revisa el manejo inicial adeacuado que debe ser tenido en cuenta por el personal medico y paramedico responsable del tratamiento de tales pacientes. Se analizan tambien algunos aspectos relacionados con las inmovilizaciones, cierre primario y tratamiento quirurgico posterior; tambien se analizan los diferentes tipos de lesiones causadas por maquinas.