ABSTRACT
There have been studied 1037 cases of hand and finger punch injuries, observed in 786 victims. An analysis of the trauma causes allowed to carry out the complex of preventive measures. The efficiency of these measures is testified by 3-fold decrease of occupational traumatism at Lysvensk metal works during 5 recent years. It has been stated that 496 (52.6%) of 945 finger and hand wounds were tissue avulsion and crush. These damages are typical ones in case of finger injuries with a punch. There have been analysed the results of treatment of 341 patient with scalped wounds, open fractures, finger and hand avulsions and crushes (482 wounds). It has been stated that careful surgical treatment of a wound with edge dissection, removal of damaged fatty tissue and free fractured fragments is a reliable method of infectious complication prophylaxis when the wound has been stitched without intention and the skin defects closed by means of the first skin plasty. The first skin plasty has been used for treatment of 62 wounds. Complete graft survival has been noted in 70.9% cases. In 85% of cases there have been obtained good functional results. A special section of sparing treatment presents finger replantation in case of their avulsion. Microsurgical technique has been applied with 9 patients. There have been replanted 13 fingers and 1 hand (survived 10 fingers and the hand). There have been revascularized 3 fingers (2 of them have survived).
