Traumatic hand injuries are an important aspect of primary care practice. Prior to beginning this activity, see physician cme information on the back page. The generalizability of these results should be limited to clinicbased patients employed in. They may result in significant shortterm and longterm impairment in function. Acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. Common injuries generally fall into two different categories. Hand tools with blades were least likely to result in multiple types of injuries, whereas powered machines or nonpowered hand tools were more likely to result in multiple types of injuries than other injury sources. Our office is located in glens falls, just minutes from saratoga springs and lake george. Mild tbi is not always associated with loss of consciousness, but mild tbi can cause. Symptoms of a tbi can be mild, moderate, or severe depending on the extent of the damage to the brain. After suffering a gunshot wound to the hand, chp officer john from thousand oak says i owe my job, i owe a big part of my life, to dr. Professionally active young workmen up to age 40 years comprise the main group involved. Table 1 presents the leading acute traumatic injuries to the upper extremity in 1994 ranked by frequency courtney and webster, 1999.
Delayed recognition or improper management of hand injuries can have longterm consequences for patients quality of life, function, and work productivity. Traumatic injuries are more likely to occur in athletes who participate in. Hand injuries interior american college of surgeons. Of acute hand injuries in the emergency department abstract although injuries of the hand are infrequently lifethreatening, they are common in the emergency department and are associated with significant patient morbidity and medicolegal risk for physicians. Traumatic injury is a term which refers to physical injuries of sudden onset and severity which require immediate medical attention. Hand injuries are among the most frequent injuries that occur to the body. Hand injury is a very common presentation both in primary care and in the accident and emergency department. Treating traumatic injuries of canine teeth in cats in. Unfortunately, hand injuries are very common and finger and hand injuries are the most.
Causes and consequences of hand injuries sciencedirect. Traumatic hand injuries account for approximately onethird of all traumatic injuries seen at state hospitals in south africa. The traumatic transaction of median or ulnar nerve in the hand usually results in impairment of function and represents a major problem for the patient. Traumatic brain injury centers for disease control and. The severity of injuries varies, often requiring only reassurance or simple dressings. Sporting injuries are particularly common and their incidence has increased in young people over the period of three decades. Hand and wrist injuries are relatively common in sport, accounting for 39% of all. Traumatic injury uf health, university of florida health. Globally, more than 50 million individuals suffer from tbis each year maas et al. The primary goal of physical therapy is to recover independent movement. Computerassisted therapy, traumatic hand injuries, hand, wrist, rehabilitation introduction hand injuries are among the most common body injuries and account for 6.
Main message primary care physicians must routinely manage patients with acute traumatic hand injuries. Intricate in design and function, the hand is an amazing work of anatomic engineering. This article outlines how to treat traumatic injuries of canine teeth in cats by using endodontic or extraction techniques. Avulsion injuries of the hand and wrist and the conditions that mimic them are commonly encountered in radiology practice, and understanding the intricate bone and softtissue anatomy can help the radiologist recognize and characterize the imaging appearance and treatment of avulsion injuries. Injuries in each zone present a unique set of issues for management and longterm outcome. The insult may cause systemic shock called shock trauma, and may require immediate resuscitation and interventions to save life and limb.
Laceration of the fingers and hand had the highest frequency and incidence rates followed by fractured finger with a. Splinting common static splints tip protector splint used for distal finger injuries for protection and support. The most common fracture injury in the athletic population occurs in the fingers. Injuries of the hand comprise approximately 10% of all emergency departbackground. Injuries to other parts of the body, especially the heart and lungs, can also cause hypoxia and anoxia of the brain. For traumatic brain injury patients, this will involve activating a mechanism known as neuroplasticity. Care of patients with acute hand injury begins with a focused history and physical.
Identifying and treating traumatic hand and wrist injuries. Epidemiology of occupational acute traumatic hand injuries. Background acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. List methods for minimizing radiation exposure during hand and finger imaging. Overuse injuries are stressinduced and include tendon inflammation and dislocation, nerve injury, and over use stress fractures. The presentation and management of nail bed injuries, fingertip amputations, mallet fingers, hand fractures, tendon lacerations, bite injuries, and infectious. Pdf the national electronic injury surveillance system reports that the fingers and hand are the most frequent body parts injured at work and treated. Although it remains the gold standard for the diagnosis of traumatic vascular injuries of the extremities 58, digital subtraction angiography has been increasingly abandoned for imaging of suspected vascular injuries to the arms and legs 1, 2, 4, 9, 10, whereas color doppler sonography 4, 29, mri, and singledetector ct angiography 17. Methods we performed a retrospective populationbased cohort study of all acute. Wrist surgery for traumatic injuries in glens falls. Proper identification and management of these injuries is critical to prevent loss of function, nerve damage, joint instability, persistent pain, or delay in indicated surgery. The bls soii provides estimates of injury characteristics for employerreported injuries resulting in at least 1dayawayfrom work daw. Cats frequently suffer dental trauma to their canine teeth, as a result of road traffic accidents, falls or fights with other animals. Stop your childs play and seek medical attention if you are concerned.
Garcia by filling out the form below or call our office at 518 7930475 today. Hand injuries occur mainly during industrial activities and professionally. Management of complications relating to complex traumatic hand. To reduce this risk, even the smallest hand injuries require proper medical evaluation. The main focus of this section is the discussion of. Occupational hand injuries were shown to cause significant longterm hand function impairment and require intensive rehabilitation.
Some common traumatic injuries in athletes include joint dislocations, sprains, muscle strains, broken bones, tendon inflammation, and ligament tears. Initial neuroassessment key history mechanism of injury response at scene neuroexamination at scene changes in neurostatus best verbal. Dip extension splint used for distal finger injuries for protection and support percutaneous pinning at distal finger dip hyperextension splint mallet fingers ulnarradial gutter splint used for fractures of the hand. Type, location, and severity article pdf available in journal of occupational and environmental medicine 444.
This guideline is a tool to aid clinical decision making. This group characteristically has constituted the youngest group of adult patients with body injuries. Approach to traumatic hand injuries for primary care. Identify limbthreatening hand injuries that require emergent hand surgery consultation. Original article effects of computerassisted wristhand. Hand and wrist injuries are common and can have a significant impact, especially if initially disregarded with a resultant delay to treatment. The aetiology of acute traumatic occupational hand. Posttraumatic stress disorder and traumatic hand injuries. A tbi is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of. Using the clinical phenomenon of posttraumatic stress disorder related to traumatic hand injuries, this article conceptually explores the theoretical construct of neurooccupation on the basis of these conditions. There are a number of injuries that may occur in an athletes hands or wrists. Neuroplasticity is the process through which the brain can repair itself after an injury.
Hand and wrist injuries are some of the most common injuries that occur in athletes of all sports and the young athlete is no exception. However, there is limited veterinary literature about the incidence and treatment options for such injuries. Traumatic brain injury tbi has been one of the leading causes of morbidity, disability and mortality across all ages bruns and hauser, 2003. The purpose of this research was to highlight the patient demographics and types of. For more information on diagnosis and treatment for traumatic hand and wrist injuries, request a consultation with dr. Substance abuse and traumatic brain injury brainline. 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. Traumatic brain injury traumatic brain injury qtbir is an injury to the brain from an external force. Pdf epidemiology of occupational acute traumatic hand injuries. Avulsion injuries of the hand and wrist radiographics. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. Hand surgeons commonly refer to five distinct flexor zones on the palmar side of the hand.
For traumatic hand injuries, i have dealt with everything from gunshot wounds to accidental amputations, and carefully evalauate treatment on a casebycase basis. Determine injury mechanism laceration, crush, burn, direct trauma. The incidence of acute traumatic tendon injuries in the. The aetiology of occupational hand injures in south africa is unknown. Management of head injury american college of surgeons. Traumatic brain injury qtbir is an injury to the brain from an external force. Physical therapy interventions for traumatic brain injury.
Mild traumatic brain injury tbi continued care guideline from page 1 approved evidence based medicine committee 51717 reassess the appropriateness of care guidelines as condition changes and 24 hrs after admission. Traumatic hand and finger injuries account for approximately 20% of all emergency department visits. Blunt trauma causes quite different injuries to penetrating trauma. Diagnosing and treating traumatic hand and wrist injuries can be challenging for clinicians in primary care, urgent care, or eds. A head injury is any injury that results in trauma to the skull or brain. Despite the frequency, few studies have examined the true incidence of acute traumatic tendon injuries in the hand and wrist or. Symptoms of a tbi can be mild, moderate, or severe depending on the extent of the damage to the. Hands, fingers, thumbs assessment and management of. Longterm disability is less likely to occur from overuse injuries than from traumatic injuries. Our skilled certified hand therapists and occupational therapists focus on specialized treatment for diagnoses ranging from traumatic hand injuries and repetitive stress injuries, to more chronic hand conditions.
Median and ulnar nerves traumatic injuries rehabilitation. Studies standard wrist xrays are insufficient 77% sensitive. Median and ulnar nerves traumatic injuries rehabilitation 263 sometimes resulting in falsenegative or falsepositive diagnosis. In addition to the large number of individuals who had a substance use disorder before their injury and return to those levels after, some studies have indicated that between 10% and 20% of persons with traumatic brain injury develop a substance use problem for the first time after their injury corrigan et al. Transient risk factors for acute traumatic hand injuries. Approach to traumatic hand injuries for primary care physicians ncbi. Discuss radiography projections and positioning for imaging injuries of hands and fingers and special considerations for portable radiography. Because head injuries cover such a broad scope of injuries, there are many causesincluding accidents, falls, physical assault, or traffic accidentsthat can cause head injuries. In zone 2, for instance, the tendons of the fds and fdp overlie one another coursing under the pulleys within the fibrous synovial sheath. Metal items, such as nails, metal stock, and burrs accounted for 38. Timely diagnosis of traumatic finger injuries is crucial in guiding management and preventing injuryrelated complications and loss of function. Her only complaint currently is pain at the base of.1490 1135 1028 1418 1107 821 970 820 499 1203 198 749 1350 858 671 1071 444 783 699 15 634 492 370 1326 902 573 985 462 1326 658 187 549 1395 511 600