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.

Non-fatal limb injuries in motorbike accidents

To determine frequency and pattern of non-fatal limb injuries in motorbike accidents victims. Cross-sectional observational study. Study was conducted at Jinnah Postgraduate Medical Centre [JPMC], Karachi, from October 2006 to March 2007. Trained data collectors prospectively collected data from the emergency department of JPMC, Karachi using structured pre-tested questionnaires. All motorbike accident victims presented to Emergency department with single or multiple bone injury in body extremities were included. Head injury patients who had first presented to neuro-surgery department were excluded. Motorbike accident victims with soft tissue injuries were also excluded from this study. Chi-square test was applied to find out statistical significance at 95% confidence level. P-value <0.05 was considered as significant. A total of 137 [39%] patients presented with tibial injury among the study sample of 348 patients, which was significantly higher than the bone injuries of the body part [p<0.001]. Out of those, in 26% of patients, fibula was also involved along with tibia fracture. Other bone injuries included femur [16%], radius [9.2%], humerus [8.3%] and others. Radius was the commonest injured bone and in highest proportion among upper limb injuries [p<0.001]. Overall, 66% of the injuries in motorbike involved lower limb fractures. The highest proportion of motorbike accidents were observed on Saturdays [31%]. Majority of the accident victims were in the age group between 16 and 30 years [41% accident cases], 27% in age group 30 to 45 years, 15% in 45 to 60 years and 5% in >60 years. Those with less than 15 years accounted for 12% of cases. Tibial bone is at the greatest risk in motorbike accidents probably due to its superficiality and exposed position while riding motorbike. Protective measures need to be taken for the prevention of disability associated with lower limb involvement in motorbike accidents

Distúrbios ortopédicos e traumatológicos: análise retrospectiva de 4.954 casos em Ambulatório de Ortopedia / Orthopedic and traumatologic diseases: retrospective study of 4954 cases in Orthopedic Ambulatory

Os autores realizaram um estudo retrospectivo, no período de janeiro a dezembro de 1997, com o intuito de estabelecer os distúrbios ortopédicos de maior prevalência, segundo sexo e faixa etária. No total, foram analisados 4.954 casos, sendo os dados obtidos junto ao banco de dados de sua instituição. Fratura do rádio e do cúbito foi o distúrbio mais prevalente (8,8 por cento), seguido de entorses e distensões (6,5 por cento). O sexo mais atingido foi o masculino (60,4 por cento) e a faixa etária mais freqüente foi entre 10 e 19 anos (18,2 por cento). Os autores discutem os resultados e comentam sobre o impacto socioeconômico dos distúrbios ortopédicos e traumatológicos

Estudio descriptivo sobre ataques y mordeduras de animales en el Município de San Juan, Puerto Rico, 1996-1998 / Descriptive study of animal attacks and bites in the municipality of San Juan, Puerto Rico, 1996-1998

The present study described the frequency of animal bites and attacks in the municipality of San Juan, Puerto Rico between the fiscal years 1996 through 1998. A total of 275 cases were reported to the San Juan Local Office of Environmental Health. The distribution of cases by gender was equal, and persons aged 18 years or older had the highest frequency of animal bites and attacks (52.9 percent). The animal species reported to be involved in the majority of animal bites was the dog (81.1 percent). Upper extremities were involved in 43 percent of these injuries. Animal bites caused by dogs were more often reported among male victims (87.4 percent) (p = 0.031). Approximately 41 percent of dog bites and attacks and 75 percent of bites and attacks caused by other animal species were documented as provoked (p = 0.002). More than 75 percent of the injuries in the head, face or neck involved children < 13 years whereas 65.9 percent of the injuries in the upper extremities involved adults (> 18 years) (p = 0.001). Animal bites and attacks in the upper extremities were more prominent among injuries caused by an animal species different to the dog (71 percent) (p < 0.001). We conclude that animal bites and attacks is a public health concern in light of the increasing pet population. Therefore, educational strategies towards the general population must stress careful supervision of the human-animal interaction as well as the general procedures to follow in case of an injury.

Pig bite in Brazil: a case series from a teaching hospital

A retrospective survey done from 1987 till 1990 revealed that 23 patients bitten by pigs sought medical help at a teaching hospital in Uberl andia, in southeastern Brazil. Most cases (21) were from Uberl andia. The cases were evenly distributed by month and by year; most of them (14/16; 87.5 per cent ) occurred between 7.00 a.m. and 7.00 p.m. The male to female ratio was 6.7:1. Age ranged from 6 to 73 (mean 38.95 +/- SD 22.06, median 36). The bites were more common on the upper limbs, particularly on the forearms. In 11 (47.8 per cent ) cases the injury was described as deep. In most cases where information was available the injury was related to capture, transport or immobilisation of the pig for slaughter. The following medical procedures were performed: local cleansing in 19(82.6 per cent ) cases, rabies vaccine (12; 52.2 per cent ), antirabies serum (2; 8.7 per cent ), suturing (6; 26.1 per cent ) and tetanus vaccine (12; 52.2 per cent ). There was no case of infection at the bite site, neither of rabies or tetanus. By our data, the annual incidence of pig bite in Uberl andia can be estimated to be about 1.5/100,000

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.