Cases reported "Hand Injuries"

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1/344. Plastic injection injury of the hand.

    A unique case of injection of plastic material into the hand is reported. Treatment was simple because the molten plastic solidified, separated readily from the surrounding tissues and could be withdrawn without fragmentation. There was no evidence of serious damage to the surrounding tissues by the plastic before it has cooled and set. The mechanism of the injury is explained and the need for simple safety precautions is noted.
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ranking = 1
keywords = injury
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2/344. thumb reconstruction in a bilateral upper extremity amputee: an alternative to the Krukenburg procedure.

    A 23-year-old man sustained traumatic loss of both hands. His left defective forearm underwent lengthening with a 3-cm segment of the ipsilateral radius; this was immediately followed by an ipsilateral second toe microvascular transfer to the stump of the radius to provide pinch. Two years after the procedure the reconstructed hand had recovery of both motion and sensibility.
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ranking = 0.00010255112919318
keywords = trauma
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3/344. Immediate autografting of bone in open fractures with bone loss of the hand: a preliminary report. case reports.

    Three patients with open fractures of the hand associated with bone loss were treated within four to six hours of injury by corticocancellous bone grafting and soft tissue coverage after meticulous debridement, copious irrigation of the wounds, and broad-spectrum antibiotics given intravenously. Long term follow-up was uneventful and showed that the graft had taken and healed well with early and full restoration of function and a good cosmetic result. Immediate corticocancellous bone grafting of an injured hand could be used in selected cases with well-debrided, surgically clean wounds as long as there is a rich blood supply. Adequate bone fixation, soft tissue coverage, and broad-spectrum antibiotics given intravenously will remove the risk of infection. Hand architecture is corrected while wound contracture and secondary deformity are avoided. Both patients' discomfort and hospital costs are considerably reduced.
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ranking = 0.2
keywords = injury
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4/344. Ultrasonic assistance in the diagnosis of hand flexor tendon injuries.

    In contrast to routine flexor tendon injuries, flexor tendon ruptures following blunt injury or re-ruptures following repair can be difficult to diagnose. The authors investigated the efficacy of using ultrasound to assist in the diagnosis. From 1996 to 1997, 8 patients underwent evaluation of the flexor tendons using an ATL HDI-3000 ultrasound machine with a high-resolution, 5 to 9-MHz hockey stick linear probe. Dynamic evaluation was performed in real time, simulating clinical symptoms. Six patients underwent surgical exploration. Sonographic diagnosis and intraoperative findings were correlated. Ultrasound was used to diagnose 3 patients with ruptured flexor digitorum profundus tendons. Mechanisms of injury included forceful extension, penetrating injury, and delayed rupture 3 weeks after tendon repair. Subsequent surgical exploration confirmed the ruptures and location of the stumps. Five patients had intact flexor tendons by ultrasound after forceful extension, penetrating injury, phalangeal fracture, crush injury, and unknown etiology. In 3 patients who underwent surgery for tenolysis, scar release, or arthrodesis, the flexor tendons were found to be intact, as predicted by ultrasound. The authors found ultrasound to be accurate in diagnosing the integrity of flexor tendons and in localizing the ruptured ends. They conclude that ultrasound is helpful in evaluating equivocal flexor tendon injuries.
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keywords = injury
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5/344. helium vapour injury: a case report.

    We report a case in which quick freeze injury occurred to both hands by helium vapour at extremely low temperatures. At the time of injury the victim was wearing protective gloves which were removed quickly after the accident. This prompt removal of gloves reduced the depth and severity of the injury. Initially he was treated by rapid thawing by immersing the hands in luke warm water (37 degrees C) and administering heparin by drip to prevent microvascular thrombosis. Delayed skin grafting was performed with good functional recovery. The circumstances accompanying this injury and preventive measures are discussed.
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ranking = 1.6
keywords = injury
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6/344. Full-thickness burn to the hand from an automobile airbag.

    An 18-year-old male was involved in a single car motor vehicle accident in which the driver's side airbag was deployed. He presented to the trauma center with complex injuries to the left hand, lacerations to the scalp, and a full-thickness burn to the ulnar aspect of the right hand that included the hypothenar area and the fifth digit. The patient was admitted to the trauma center and received immediate consultation from the burn service. He underwent debridement and split-thickness skin grafting of 50 cm2 of the right hand on postburn day 3. The graft became necrotic and the patient underwent debridement of the skin and the abductor minimi muscle of the right hand on postburn day 32. Split-thickness skin grafting and release of flexion contracture were successfully completed 18 days later. The police and fire departments reported that the airbag showed signs of thermal destruction. Upon request, Honda motors submitted information from the TRW safety systems and material safety data sheet (Mesa, Ariz, issued 1989) that showed that airbag canisters contain the chemicals sodium azide and cupric oxide. water may react with sodium azide to form highly toxic and explosive hyfrazoic acid. These chemicals are converted to sodium hydroxide, which can cause significant chemical burns. In addition, these chemicals may ignite when exposed to live electrical wires or temperatures greater than 300 degrees F. We conclude that burns associated with damaged deployed airbags in motor vehicle accidents may be the results of both chemical and thermal injury. The extent of the burn wound may be underestimated, as our case illustrates. Full-thickness burns resulting from airbag deployment may require more aggressive initial debridement and treatment.
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ranking = 0.20093010067048
keywords = injury, laceration, trauma
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7/344. Physical therapy after hand injuries.

    The nuances of physical therapy necessary in the trauma patient are discussed. This article also discusses either the treatment of fractures via therapy or the treatment of nerve, tendon, or arterial injuries. It also describes physical therapy guidelines relevant to the patient with hand trauma and reviews communication between the physician and therapist in managing these patients. Intervention concepts are illustrated through case studies of patients with complex hand injuries.
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ranking = 0.00020510225838636
keywords = trauma
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8/344. The role of emergency free flaps for hand trauma.

    Primary closure of a wound with free flap requires minimizing the risk of infection in an effort to cover vital exposed structures. Careful patient selection, radical debridement of the wound, and an experienced microsurgical team are important for the routine application of this technique. Primary reconstruction of all injured structures is an extension of this technique that enables efficient management of severe upper extremity problems in a single setting.
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ranking = 0.00041020451677272
keywords = trauma
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9/344. Development of Peyronie's and Dupuytren's diseases in an individual after single episodes of trauma: a case report and review of the literature.

    A case is presented in which a patient experienced the development of both Dupuytren's disease and Peyronie's disease after single episodes of sports-related trauma. These disorders and other fibromatoses are linked not only by similar pathologic features but by increased frequency of simultaneous occurrence. Some genetically predisposed individuals experience the development of the disorders after trauma or after some other factor unmasks that predisposition. A review of the literature with emphasis on the relationship between these fibromatoses and the varied nonsurgical attempts at treatment is presented.
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ranking = 0.00061530677515908
keywords = trauma
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10/344. Hemophilic pseudotumor of the soft tissue of the hand: a case report.

    A 25-year-old, right hand dominant man with a history of hemophilia a, presented with an enlarging 2 x 3.5 cm mass on the dorsum of his dominant hand following minor trauma. factor viii activity level was 12 percent of normal. A diagnosis of hemophilic pseudotumor was made and the mass continued to enlarge despite medical management. Surgical intervention was carried out in order to prevent impending skin necrosis or rupture. The patient was treated by surgical excision of the lesion along with factor replacement therapy. The patient's symptoms resolved and he had no recurrence of the tumor.
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ranking = 0.00010255112919318
keywords = trauma
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