Estudio de las heridas por amoladora tratadas en el Hospital de Clínicas y Hospital Pasteur, Montevideo, Uruguay / Grinder injuries treated at the Clínicas and Pasteur Hospital of Montevideo, Uruguay / Estudo das lesões por esmerilhadeira tratadas no Hospital de Clínicas e Hospital Pasteur, Montevidéu, Uruguai

Resumen: Introducción: las heridas causadas por amoladora representan una consulta frecuente al cirujano plástico en nuestro país. Los objetivos del presente trabajo fueron conocer la epidemiología de los pacientes que consultaban con estas lesiones, conocer las circunstancias del accidente y estudiar si existía relación entre las condiciones de uso de la herramienta y la gravedad de las lesiones. Material y método: se realizó un estudio descriptivo, transversal, donde se recabaron los datos de los pacientes que consultaban por heridas por amoladora en las puertas de emergencia de Hospital Pasteur y Hospital de Clínicas en un período de 6 meses. Resultados: un total de 76 pacientes fueron incluidos en el estudio, la mayoría de sexo masculino, en edad laboral activa (39 a 58 años) dedicados a la realización de trabajos temporales o tareas de construcción, con bajo nivel de instrucción. El 84% de las heridas fueron graves. El 61% de los pacientes no utilizó los elementos de seguridad de la herramienta al momento del accidente. La mayoría de las lesiones se produjeron fuera del ambiente laboral. Conclusiones: en base a nuestro trabajo pudimos establecer el perfil epidemiológico de la población más susceptible de sufrir estas lesiones. Comprobamos que las heridas producidas por amoladora son en su mayoría graves y requieren procedimientos complejos para su resolución.

Summary: Introduction: grinder injuries represent a large number of consultations for plastic surgeons in our country. This study aims to learn about the epidemiological characteristics of patients who consulted for these lesions and the circumstances of the accidents, and to analyze whether there is a relationship between the conditions for tool use and the severity of lesions. Methodology: we conducted a retrospective, descriptive, transversal study where we collected data from the patients who consulted for grinder injuries at the emergency departments of Pasteur and Clínicas Hospital during a 6-month period. Results: seventy-six patients were included in the study, most of which were male working adults (between 39 and 58 years-old) who had temporary jobs or were performing construction works and had low levels of education. 84% of lesions were severe. 61% of patients did not respect safety regulations at the time of the accident. Most lesions occurred out of working hours. Conclusions: based on our study, we could identify the epidemiological profile of the most vulnerable population for this kind of lesions. We proved that most grinder lesions are severe and their management requires complex procedures.

Resumo: Introdução: as lesões causadas por esmerilhadeira são causa frequente de consulta ao cirurgião plástico no Uruguai. Os objetivos do presente trabalho foram conhecer as características dos pacientes que consultaram com essas lesões, conhecer as circunstâncias do acidente e analisar a possível relação entre as condições de uso da ferramenta e a gravidade das lesões. Metodologia: foi realizado um estudo descritivo, transversal, onde foram coletados dados de pacientes que consultaram por lesões de esmerilhadeira no pronto-socorro do Hospital Pasteur e Hospital de Clínicas durante um período de 6 meses. Resultados: foram incluídos no estudo 76 pacientes, a maioria do sexo masculino, em idade ativa para trabalhar (39 a 58 anos) dedicados à realização de trabalhos temporários ou trabalhos na construção civil, com baixo nível de escolaridade. 84% dos ferimentos foram graves. 61% dos pacientes não utilizaram os elementos de segurança da ferramenta no momento do acidente. A maioria das lesões ocorreu fora do ambiente de trabalho. Conclusões: com base em nosso trabalho conseguimos estabelecer o perfil da população mais suscetível a esses agravos. Constatamos que a maioria das lesões causadas por esmerilhadeiras são graves, exigindo procedimentos complexos para sua resolução.

Evaluation of Circular Saw Injuries in a Reference Center in Microsurgery and Reimplantation / Avaliação de lesões por serra circular em um centro de referência em microcirurgia e reimplantes

Abstract Objective To evaluate the epidemiologic profile, the time until care, and the type of conduct taken regarding patients who are victims of accidents with circular saws and their resulting injuries, and to make a comparison with the literature. Methods A cross-sectional descriptive study reviewing the medical records of patients cared for from April to December 2018, analyzing age, gender, injured side, affected fingers, month and time of the accident, type of injuries, procedures performed in the emergency room, time elapsed between trauma and admission to the operating room, and reapproach during hospitalization. Results A total of 54 male patients aged between 15 and 72 years were care for. The left side was more affected, and the most frequent type of lesion involved the thumb, which had to be amputated in many cases. In total, 23 patients underwent reimplantation, 3 of which were macroreimplantations. Regarding the time of trauma, 26 cases occurred between noon and 4 p.m., and the time elapsed between the accident and the admission to the operating room was ≥ 6 hours in 84% of the patients. Conclusion Circular saw lesions are predominantly severe, with a potential for leaving permanent sequelae, and they affect mainly the thumb. The characterization of the type of injury and the initial care conditions obtained in the present study may contribute to the policy of prevention and care of patients who are victims of circular saw injuries. Level of Evidence IV; Case Series.

Resumo Objetivo Avaliar o perfil epidemiológico, o tempo até o atendimento, e o tipo de conduta tomada em pacientes vítimas de acidentes com serra circular e lesões decorrentes, e fazer uma comparação com a literatura. Métodos Estudo descritivo transversal, com revisão do prontuário de pacientes atendidos de abril a dezembro de 2018, analisando idade, sexo, lado lesado, dedos acometidos, mês e horário do acidente, tipo de lesões, procedimentos realizados na urgência, tempo decorrido entre o trauma e entrada em sala cirúrgica, e reabordagem durante a internação. Resultados Foram atendidos 54 pacientes do sexo masculino com idade entre 15 e 72 anos. O lado esquerdo foi o mais acometido, e o tipo de lesão mais frequente, a amputação, envolvendo principalmente o polegar. No total, 23 pacientes foram submetidos a reimplante, e, entre eles, 3 macrorreimplantes. Quanto ao horário do trauma, 26 ocorreram entre 12h e 16h, e o tempo decorrido entre o acidente e a entrada em sala cirúrgica foi ≥ 6 horas em 84% dos pacientes. Conclusão As lesões por serra circular são predominantemente graves, com potencial de deixar sequelas permanentes, e acometem principalmente o polegar. A caracterização do tipo de lesão e as condições de atendimento inicial obtidas neste trabalho poderão ajudar na política de prevenção e atendimento a pacientes vítimas de ferimentos por serra circular. Nível de Evidência IV; Série de Casos.

Circular saw misuse is related to upper limb injuries: a cross-sectional study

OBJECTIVES: Machinery injuries account for a substantial share of traumatic upper limb injuries (TULIs) affecting young active individuals. This study is based on the hypothesis that there is an important relationship between the improper use of power saws and TULIs. The aim of the study is to assess the prevalence and epidemiology of TULIs caused by power saws and determine the risks related to power saw use. METHODS: A cross-sectional evaluation of medical records from a two-year period was performed. Patients sustaining TULIs related to power saws were analyzed. Data on the epidemiology, site of injury, mechanism of trauma, technical specifications of the tool, cutting material, personal protective equipment, time lost and return to work were obtained. RESULTS: A database search retrieved 193 TULI records, of which 104 were related to power saws. The majority of patients were male (102/104; 98.1%), right-handed (97/104; 93.3%), and manual workers (46/104; 44.2%), with an average age of 46.8 years. The thumb was the most frequently injured site (32/93; 34.4%). Most of the injuries were caused by manual saws (85/104; 81.7%), and masonry saws accounted for 68.2% (58/85) of the cases. Masonry saws improperly used for woodwork resulted in 86.2% (50/58) of the injuries. TULI caused by masonry saws was 5 times higher in manual workers than in other patients. In addition, masonry saws had a risk of kickback 15 times higher than that of other saws, and the risk of injury increased by 5.25 times when the saws were used improperly for wood cutting. CONCLUSIONS: The profile of TULIs related to power saws was demonstrated and was mainly associated with manual saws operated by manual workers that inappropriately used masonry saws for woodworking.

Epidemiology and patterns of the hand and distal forearm fractures at King Abdul-Aziz Medical City, Riyadh, KSA

Objectives: The hand is the most commonly fractured site in the body, as it represents 17-25% of all body fractures. The metacarpal bone of the small finger is the most commonly fractured hand bone. This study aimed to determine the epidemiology and frequency of various fractures of the hand and the distal forearm in adults with a view to identifying patients who required surgical treatment

Methods: This retrospective review examined the medical records of all hand and distal forearm X-rays performed on adult patients who presented to the emergency room of King Abdul-Aziz Medical City from January 2010 to December 2011

Results: In this study, we reviewed 2993 X-rays of the hand and the distal forearm. One-third of these X-rays confirmed fractures [n = 948], and more than two-thirds of these fractures were recorded in male patients [n = 702]. There was no major difference in the distribution of fractures between the left and right hand. Half of these fractures [n = 472] were found in the young age group [18-30 years]. The study showed that the phalanges had the highest proportion of fractures [n = 362, 40%]. Distal forearm fractures represented one-third of all registered fractures [n = 287]. Almost half of the metacarpal fractures were found in the 5th metacarpal [n = 104], confirming that the 5th metacarpal bone is the most commonly fractured bone in the hand. One-fifth of all fractures were surgically managed [n = 190, 20%]

Conclusion: One-third of the reviewed X-rays identified hand and distal forearm fractures. Both hands were affected equally. Patients in the young age group are more prone to have fractures, and phalanges had the highest proportion of fractures followed by the distal forearm

The Incidence of Acute Traumatic Tendon Injuries in the Hand and Wrist: A 10-Year Population-based Study

BACKGROUND: Acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. Despite the frequency, few studies have examined the true incidence of acute traumatic tendon injuries in the hand and wrist or compared the incidences of both extensor and flexor tendon injuries. METHODS: We performed a retrospective population-based cohort study of all acute traumatic tendon injuries of the hand and wrist in a mixed urban and rural Midwest county in the United States between 2001-2010. A regional epidemiologic database and medical codes were used to identify index cases. Epidemiologic information including occupation, year of injury, mechanism of injury and the injured tendon and zone were recorded. RESULTS: During the 10-year study period there was an incidence rate of 33.2 injuries per 100,000 person-years. There was a decreasing rate of injury during the study period. Highest incidence of injury occurred at 20-29 years of age. There was significant association between injury rate and age, and males had a higher incidence than females. The majority of cases involved a single tendon, with extensor tendon injuries occurring more frequently than flexor tendons. Typically, extensor tendon injuries involved zone three of the index finger, while flexor tendons involved zone two of the index finger. Work-related injuries accounted for 24.9% of acute traumatic tendon injuries. The occupations of work-related injuries were assigned to major groups defined by the 2010 Standard Occupational Classification structure. After assigning these patients' occupations to respective major groups, the most common groups work-related injuries occurred in construction and extraction occupations (44.2%), food preparation and serving related occupations (14.4%), and transportation and material moving occupations (12.5%). CONCLUSIONS: Epidemiology data enhances our knowledge of injury patterns and may play a role in the prevention and treatment of future injuries, with an end result of reducing lost work time and economic burden.

Perfil dos pacientes com lesões traumáticas do membro superior atendidos pela fisioterapia em hospital do nível terciário / Profile of patients with traumatic injuries of the upper limb treated in a tertiary hospital

A incidência de lesões traumáticas dos membros superiores em um hospital terciário além de ser elevada, possui uma grande variedade. Neste sentido torna-se importante a criação de um banco de dados único, para conhecer o perfil dos pacientes atendidos. Objetivo: traçar o perfil dos pacientes com lesões traumáticas dos membros superiores, atendidos pela Fisioterapia no Centro de Reabilitação do Hospital das Clínicas de Ribeirão. Método: foram avaliadas 223 fichas de pacientes (58 mulheres e 116 homens), com idade média de 34,54 (± 19,05) anos, encaminhados pelo ambulatório de ortopedia do referido hospital. Resultados: do total de casos analisados, as lesões de punho e mão obtiveram maior incidência (60,99%), seguidos por lesões de ombro (20,63%), cotovelo (12,55%), braço (3,59%) e antebraço (2,24%). Nas lesões de punho e mão o mecanismo de trauma com maior porcentagem foi o acidente de moto, relacionado com as fraturas múltiplas de ossos da mão. Queda da própria altura, acidente motociclístico e queda de escada foram os mecanismos de trauma, correlacionando com as fraturas de úmero proximal, luxação de ombro e fraturas de escápula respectivamente. Conclusão: Foi verificada a incidência de lesão, mecanismo de trauma e as características da população para futuramente aprimorar os protocolos específicos para as disfunções e investir em campanhas de prevenção.

The incidence of traumatic injuries of the upper limbs in a tertiary hospital has a wide variety. This is why the creation of a unified database becomes important-to know the patients’ profile. Objective: this study sought to determine the profile of patients with traumatic injuries of the upper limbs, treated by Physical Therapy in Rehabilitation Center of the Clinics Hospital of Ribeirão Preto. Method: Two hundred and twenty-three patient records were evaluated (58 women and 116 men). They had an average age of 34.54 (± 19.05) years and were referred by the orthopedic clinic of this hospital. Results: of the cases studied, wrist and hand injuries had the highest incidence (60.99%), followed by injuries of the shoulder (20.63%), elbow (12.55%), arm (3.59%) and forearm (2.24%). In injuries of wrist and hand, the trauma mechanism with the highest percentage was the motorcycle accident, associated with multiple handbone fractures. Falling down, motorcycle accidents, and falling off a ladder were the mechanisms of injury correlated with proximal humerus fractures, shoulder dislocations, and broken scapulas, respectively. Conclusion: the incidence of injury, trauma mechanism, and characteristics of the population was verified and further improvements in protocols for specific disorders and prevention can be made.

[Repeatability assessment of quantified measurement method in hand drawing skills]

Because of high incidence of hand injuries and the need for a quantitative method that provides measures of patient improvement in treatment period a precise and easy-to-apply quantitative procedure is necessary. As a first step in validating of such a method, the intersession repeatability of quantified measures was assessed in this study. Measurement of hand drawing skills by drawing circle shape in two speeds [preferred and maximum] and spiral shape just in a preferred voluntary speed with two repetitions for each subject was assessed in 15 subjects. Digital data was recorded by a Tablet PC using special software with average sampling rate of 120 Hz. The quantified variables computed for circle and spiral drawing tests with preferred speed were reliable [0.55 < ICC < 0.85], so they can be used for drawing quantifications. Results of drawing circles with maximum speed were not reliable [ICC < 0.5]. Repeatability analysis revealed that measures based on drawing circles with maximum speed are not repeatable and cannot be used for process monitoring. This may be due to large variation in providing maximum drawing speed during test time. On the other hand, spiral and circle drawing parameters with preferred speed had a better repeatability and can be used for quantification of hand drawings in researches

Necesitamos revisar las heridas en dorso de mano y antebrazo / Nécessité de la mise en charge des blessures du dos de la main et l'avant-bras / It is necessary to inspect the wounds in hand dorsum and forearm

INTRODUCCIÓN: Las lesiones en dorso de mano son urgencias frecuentes de un hospital. Estudiar la relación existente entre la clínica inicial y la afectación tendinosa subyacente en heridas localizadas en esta región. Así como valorar la localización exacta, tipo, y etiología de ellas, por medio de un estudio observacional. MÉTODOS: Se realizó un estudio transversal, en el que se valoran 51 pacientes con 55 heridas en dorso de mano y antebrazo, tratadas en urgencias de nuestro hospital durante el periodo de junio a diciembre de 2009. RESULTADOS: La exploración inicial nos ofrece una especificidad y un valor predictivo positivo del 100 por ciento, pero una sensibilidad del 17,14 por ciento y un valor predictivo negativo del 40,81 por ciento con respecto a la presencia de lesión tendinosa. CONCLUSIÓN: Ante la falta de correlación entre la clínica inicial con una posible lesión tendinosa extensora recomendamos la exploración quirúrgica de las heridas en dorso de mano, por su sencillez y aprovechamiento del acto quirúrgico(AU)

INTRODUCTION: Injuries in hand dorsum are frequent hospital emergences. It is necessary to study the relation between initial clinics and the tendinous injuries underlying in wounds present in this region, as well to assess its exact location, the type and etiology through observational study. METHODS: A cross-sectional study was conducted to assess 15 patients presenting with wounds in the hand dorsum and forearm, treated in emergency room of our hospital from June to December, 2009. RESULTS: The initial screening offer us a specificity and a positive predictive value of the 100 percent, but a sensitivity of 17,4 percent and a negative predictive value of 40,81 percent regarding the presence of the tendinous injury. CONCLUSION: Due to a lack of correlation between the initial clinics and a possible extensor tendinous injury, it is recommended the surgical exploration of hand dorsum injuries due to its simplicity and use of surgical act(AU)

INTRODUCTION: Les lésions du dos de la main sont des urgences fréquentes d'un hôpital. Le but de cette étude est d'étudier la relation existant entre la clinique initiale et l'affection tendineuse sous-jacente des blessures localisées à cette région, et d'évaluer la localisation exacte, le type et l'étiologie par une étude observationnelle. MÉTHODES: Une étude transversale, portant sur 51 patients atteints de blessures (55) au dos de la main et l'avant-bras, et traités au service des urgences de notre hôpital entre juin et décembre 2009, a été réalisée. RÉSULTATS: L'exploration initiale nous montre une spécificité et une valeur pronostique positive de 100 percent, mais une sensibilité de 17,14 percent et une valeur pronostique négative du 40,81 percent par rapport à la présence des lésions tendineuses. CONCLUSIONS: Devant l'absence de corrélation entre la clinique initiale et une possible lésion du tendon extenseur, il est conseillé de faire une exploration chirurgicale des blessures du dos de la main, car elle est simple et très utile(AU)

Accidentalidad por fluidos biológicos en profesionales de laboratorios clínicos de Maracaibo, Venezuela / Biological fluid-related accidents amongst professionals working in clinical laboratories in Maracaibo, Venezuela

Objetivo Determinar la exposición laboral accidental a fluidos biológicos por contacto percutáneo en el personal Bioanalista de Laboratorios Clínicos públicos, sus factores asociados y el cumplimiento de medidas post exposición biológica. Métodos Se realizó un estudio descriptivo transversal, la muestra fue de 156 bioanalistas adscritos a laboratorios clínicos del área metropolitana del estado Zulia. Para la recolección de datos se aplicó un instrumento de escalas que exploró la exposición percutánea, los factores vinculados y el cumplimiento de medidas post exposición biológica. Resultados Se evidenció exposición por accidentes percutáneos, representados principalmente por pinchazos y cortaduras, detectados en razón de su ocurrencia en un nivel moderado (media entre 2-3,99). Como factores vinculados a la accidentabilidad percutánea, se registra la ocurrencia en nivel moderado con diversas agujas huecas, con sangre y hemoderivados, en manos y dedos, con una severidad superficial, en áreas de toma y procesamiento de muestras durante el re-encapuchado de objetos punzo cortantes. Un nivel de mediano cumplimiento se obtuvo para el manejo post exposición. Existe relación entre la exposición percutánea con el nivel de cumplimiento detectado para el manejo post exposición p <0,001. Conclusión La magnitud y características de la exposición a fluidos biológicos detectada en este colectivo laboral reviste una problemática que puede impactar en la salud del personal y debe ser abordada institucionalmente para una efectiva gestión de prevención y control de riesgo.

Objective Determining the occupational exposure to biological fluids of medical technicians working in public clinical laboratories caused by accidental percutaneous contact, associated factors and compliance with post-exposure biological measures. Methods This was a descriptive cross-sectional study. The sample consisted of 156 medical technicians assigned to clinical laboratories in the metropolitan area of Zulia state in Venezuela. Data was collected by applying an instrument for exploring exposure and related factors, as well as compliance with established post-biological exposure measures. Results There was evidence of exposure caused by percutaneous accidents, mainly represented by a moderate level of needle-pricks and cuts (2-3.99 mean). There was a moderate level of factors regarding percutaneous injury in the hands and fingers associated with hollow needles, blood and blood products and superficial severity in sample taking and processing areas when recapping needles or handling sharp or cutting objects. A medium level (2-3.99 mean) of compliance was obtained for post-exposure handling. A significant correlation was found (p<001) between percutaneous exposure and level of compliance with post-exposure management. Conclusion The magnitude and characteristics of exposure to biological fluids detected in this work represents a problematic situation which can affect staff health and must be approached by institutions to ensure effective prevention management and risk control.

Prevalência de lesões na temporada 2002 da Seleção Brasileira Masculina de Basquete / Prevalence of injuries of Brazilian Basketball National Team during 2002 season

Este estudo objetiva apresentar a prevalência, provável etiologia e localizaçäo das lesöes da Seleçäo Brasileira de Basquete masculina adulta durante a fase de preparaçäo e o 14º Campeonato Mundial de Basquetebol, em 2002. No total, foram 102 queixas correspondendo ao período de 1/7/02 a 10/9/02, com média de 2,55 lesöes/mês/jogador. Encontrou-se maior índice de lesöes atraumáticas, incluindo as musculares, doenças sistêmicas e lesöes tendinosas (66/102 queixas), ou seja, 64,7 por cento do total. Dentre as lesöes traumáticas, as mais freqüentes foram as entorses de tornozelo (13/102 lesöes) com 12,8 por cento, seguidas dos traumas diretos (contusöes) na regiäo das mäos (9/102 lesöes), com 8,8 por cento. Em relaçäo ao local de acometimento, as maiores queixas foram nos membros inferiores (49 /102), com 48,0 por cento e membros superiores (14/102), com 13,7 por cento. Quanto à gravidade, lesöes leves representaram 57,8 por cento, seguidas das moderadas e graves, com 32,4 por cento e 9,8 por cento, respectivamente. Em relaçäo à posiçäo de jogo, os pivôs foram os atletas que apresentaram maior número de queixas, 45, representando 44,1 por cento do total, sendo estas devido, principalmente, ao contato físico na regiäo do garrafäo. Dessa forma, por ser um esporte de extremo contato, as lesöes traumáticas, principalmente em mäos e coxas, e as entorses de tornozelo säo altamente representativas, sendo os membros inferiores os mais acometidos

Accidentes de la mano en trabajadores de la costa oriental del lago de Maracaibo del Estado Zulia, Venezuela, 1986-1993 / Hand injuries in workers on the eastern shore of Marcaibo Lake in the state of Zulia, Venezuela, 1986-1993

In order to analyze the frequency, injury rate and cause of on site accidents to the hands of workers on the east coast of lake of Maracaibo in Zulia State, data was obtained from the accident reports registered with the Venezuelan Institute of Social Security. An occupational hand injury was defined as a traumatic injury to the hands, fingers or wrists that occurred while the employee was at work; that resulted from a single exposure to a hazardous agent. The following variables were analyzed: age, severity, economic activity, material agent, mechanic cause, type of injury, type of accident and unsafe action. The frequency rate was used to analyze the annual accident rate. During the period under study 2.456 injuries to the hand were registered, representing 36 of the total injuries reported; 95 were light injuries, 5 incapacitating and two cases resulted in the death of the worker. 72 of the injuries were located in the fingers, 22 in the hands and 6 in the wrists. The greatest frequency of injuries were found in the economic activity in mines and quarries with a rate of 123.1 per thousand. The age group most affected was of 20-29 years (42), Wounds or contusions and crushings were the injuries most commonly reported, in 39 and 36 of the cases respectively. The main type of injuries were caused by run over, running into or blow from objects. The principal agents causing injuries were materials, substances and radiations in 45 of the cases. It is concluded that the hand injury rate is very high in the exploitation of mines and quarries and represents the main cause of worker's disability.

Trauma complexo de mao: análise epidemiológica na Unidade de Cirurgia Plástica do Hospital Regional da Asa Norte/FHDF/SeS / Complex Hand Injury - Epidemiological Analysis in the Plastic Surgery Unit of Hospital Regional da Asa Norte, Distrito Federal

O presente trabalho tem por objetivo analisar os aspectos epidemiológicos do traumatismo complexo de mao atendido na Emergência da Unidade de Cirurgia Plástica do Hospital Regional da Asa Norte. Durante 3 meses foram atendidos 522 casos de trauma de mao, 1/3 do atendimento da emergência da cirurgia plástica. A maioria dos acidentes ocorreram no sexo masculino , entre 20 e 40 anos, causados por acidentes de trabalho (34 por cento) e agressao física (20 por cento). Os acidentes de trabalho atingem principalmente marceneiros, provocados por equipamentos mecânicos, destacando-se a serra elétrica. O horário de maior ocorrência é das 7 às 12 horas. O dedo indicador tanto foi o mais lesado, como o mais amputado. As amputaçoes foram as lesoes mais freqüentes, apenas 7 por cento usava equipamento de proteçao, metade dos casos sem vínculo empregatício. As agressoes físicas ocorreram no período de 0 às 12:00 horas, provocadas por objeto cortante, vidro e faca, ocasionando lesoes de tendoes e nervos. Existem dois grupos distintos de lesoes complexas de mao, de interesse de saúde pública, que merecem estudo para adoçao e implementaçao de medidas preventivas

The pattern of tissue damage in occupational trauma.

OBJECTIVE: To study the pattern of tissue damage in occupational hand injuries. SETTING: Trauma and Orthopaedic Unit of the General Hospital, Colombo. PATIENTS: 190 patients with occupational hand injuries submitted to surgery by me were studied prospectively. The incidence of compound and simple fractures and dislocations, digital amputations, tendon injuries and skin loss were studied. The individual bones and tendons affected, the level of digital amputations and the involvement of individual fingers were recorded. RESULTS: Compound fractures accounted for 42.1% of injuries and in 56.4% the distal phalanx was involved. Finger tendons were affected in 66.6%. The highest incidence of compound fractures (30.6%), amputations (41.1%) and skin and subcutaneous tissue loss (28.5%) was seen in the index finger. CONCLUSIONS: 1. Compound fractures and digital amputations were the main injuries. 2. Distal phalanx is more frequently affected in compound fractures. 3. Among the amputations loss of finger tip is the commonest. 4. Flexor tendons were more injured than the extensor tendons. 5. Index finger is the most frequently injured digit.

Morbilidad quiriurgica en el Servicio de Ortopedia y Traumatologia / Surgical morbidity in orthopedics and traumatology service

Se realizo un estudio sobre la morbilidad quirurgica en el servicio de Ortopedia y Traumatologia durante el periodo comprendido entre diciembre de 1991 y junio de 1993. Las lesiones de cade ra fueron mas comunes en nuestro medio, y las reducciones y osteosintesis, el procedimiento quirurgico mas utilizado

Traumatismos da mäo nos acidentes de trabalho em Caxias do Sul / Hand injuries in occupational accidents in Caxias do Sul

Em Caxias do Sul, no período de janeiro a maio de 1993, foram avaliados 500 acidentados no trabalho que tiveram a mao como local atingido, tendo recebido atendimento na Carteira de Acidentes do Trabalho (CAT), anexo ao Hospital Saúde Ltda., onde foram tratados e acompanhados. A maioria desses pacientes sao do sexo masculino (87 por cento), com idade entre 21 e 30 anos (37 por cento). Os dedos foram os locais mais afetados (79,6 por cento) e os ferimentos predominaram sobre as demais lesoes. O tempo médio de tratamento foi de 22 dias. Os autores ressaltam a importância de uma adequada prevençao com relaçao aos acidentes no trabalho com o intuito de diminuir os altos números obtidos neste estudo.

Traumatismos de la mano en niños / Hand injuries in children

Se llevó a cabo un estudio epidemiológico, retrospectivo y prospectivo en un periodo de un año, de octubre de 1990 a septiembre de 1991, con el objeto de determinar las cifras de lesiones de la mano en niños menores de 12 años, en el cual se encontró que, del total de urgencias atendidas en el lapso citado, que fueron 53,958, la cantidad de 982, es decir, el 1.8 por ciento correspondieron a los casos mencionado. Hubo predominio del sexo masculino, con 59.2 por ciento. La mano derecha estuvo más frecuentemente afectada, con un 64.6 por cient; en el 65.7 por ciento de los casos estuvo lesionada únicamente la piel; en el 14.1 por ciento hubo lesiones óseas con predominio de los deslizamientos epifisiarios; en el 12.6 por ciento de los casos hubo lesiones de varias estructuras; el 4.6 por ciento tuvieron lesiones tendinosas; hubo lesiones de más de dos dedos en el 1.9 por ciento y finalmente hubo lesiones nerviosas en sólo 0.8 por ciento de los casos

Prevençäo de acidentes e atendimento de emergencia de lesöes traumáticas da mäo na área metropolitana de Säo Paulo / Accident prevention and emergency medical services of hand injuries lesions in the metropolitan area of Säo Paulo

A mäo, "ferramenta de trabalho", é o maior bem do trabalhador. A selecçäo e o treinamento do trabalhador, associados a medidas preventivas, por parte do empregado e da empresa, tornam o trabalho mais humano e produtivo. A incidência de lesöes de mäo em nossa cidade é muito grande (cerca de 500 por dia) e o seu custo é de milhöes. O primeiro atendimento dessas lesöes é muito precário, merecendo po conceito de "segundo acidente". O CIPAM-SUDS/SP proporcionará atendimento mais simples e eficiente, ministrado por cirurgiöes treinados e em plantäo permanente, em postos situados longe do centro, em áreas industriais

Orthopaedic industrial injuries.

A study of 600 consecutive cases of industrial injuries, who came from power using mechanised industries at Jaipur was undertaken to determine the incidence, pattern and causes of industrial injuries. The study revealed that there were fewer injuries in the 18 to 25 years age group than in those over the age of 36. Most of the injuries involved the upper limbs (66.2%), of which nearly 41% resulted from entrapment of hands in machines and were serious. This reflected the lack of adequate safety measures where it is most required.