1/18. 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.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/18. A stingray injury in a devotee of aquarium fishes.The stingray is one of the most dangerous fishes for man. The sting is poisonous and causes a painful wound. Fatalities are reported. Most injuries due to stingrays occur in coast regions of the tropics and subtropics. Therefore, physicians in countries with a moderate climate are less informed about the management about these kinds of injuries. The characteristics, treatment and prevention are discussed in connection with a case that occurred in belgium in a devotee of aquarium fishes.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/18. High-pressure injection injuries to the hand.High-pressure injection injury hides the true extent of the lesions behind an apparent small and harmless puncture of the finger or the hand. Through clinical description, we wish to point out the need for prompt treatment to avoid mutilating and function-threatening complications. We wish to outline the role of the emergency physician who must be aware of the incidence of high-pressure injection injury and become accustomed to early referral to a surgeon, experienced in extensive surgical exploration, removal of foreign bodies, and rehabilitation. The open-wound technique gives the best results. We also point out that failure to refer may become an increasing focus of negligence claims.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/18. Hyperbaric oxygen treatment in deep frostbite of both hands in a boy.An 11-year-old boy in good general health conditions suffered deep frostbite on six fingers while he was working without gloves as a beater during a hunt in poland at an outdoor temperature of -32 degrees C over a 4 h-period. Three days later he was first seen by a physician who planned to amputate the affected fingers. The patient was transferred by his family to our University Hospital in Aachen, germany. We found third degree frostbite on four fingers of the right and on two fingers of the left hand. Because of the late beginning of the therapy, the patient was treated by HBO(2) according to the Marx-schema for problem wounds (2,4 bar, total time at depth: 90 min, alternations of 100% O(2) and air breathing). HBO(2)-treatment was repeated daily for 14 days. No adverse events were recorded during the course of therapy. A total recovery of the severe frostbite was observed after 14 days of HBO(2)-treatment. Twenty-eight months after the injury the patient reports fully regained sensibility and no pain. The plain X-ray after this period showed no premature closure of the epiphyses or sclerosis of the metaphyses. Conclusions: Because of the low risk associated with HBO(2), and its potential therapeutic efficiency, HBO(2) should be recommended as adjunct therapy in the treatment of deep frostbite.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/18. Manual demands and consequences of rock climbing.Types of rock climbing, hand-grip techniques, and training practices used by rock climbers are described. A survey was completed by 46 climbers. Three fourths of the climbers reported a climbing-related injury; of these injured climbers, almost one half reported a hand or wrist injury. More than half of the injured climbers had been treated by a physician for their injury. More than half of all climbers reported distal interphalangeal or proximal interphalangeal joint pain while climbing. case reports of three climbers with acute hand injuries are presented to illustrate the minimal effects of their residual deficits on their climbing abilities. A wider understanding of the manual aspects of rock climbing and an awareness of the patterns and incidence of injuries in this sport will facilitate prevention, treatment, and rehabilitation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/18. 7 cases of hydrofluoric acid burn in which calcium gluconate was effective for relief of severe pain.We report 7 cases of chemical burns due to hydrofluoric acid (HF). The patients suffered from severe pain. However, the pain was relieved after treatment with calcium gluconate. 6 out of the 7 cases were men. At the accidental exposures, all the patients had been engaged in washing or cleaning work and received burns on their hands and/or fingers. In one case, the forearm was also involved. During such work, all the patients had used rubber gloves, but the gloves had pinholes. For the treatments, 4% calcium gluconate jelly was applied in 5 cases and 4 of 7 were subcutaneously injected with 8.5% calcium gluconate. The involved nails were removed in 5 cases. It is concluded that physicians should provide calcium gluconate jelly and subcutaneous injections to treat an HF burn and should not hesitate to remove the involved nails. To prevent chemical burn due to HF, education and reeducation of workers regarding the hazard of this chemical are necessary.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/18. Hand lesions characteristic of bulimia.bulimia is a serious and prevalent eating disorder in the adolescent population. The pediatrician is often in a position to make the initial diagnosis of bulimia but must suspect the disorder in light of subtle physical evidence. Denial and embarrassment reduce the likelihood of self-report of symptoms. Hand lesions resulting from self-induced emesis have a distinctive configuration and appearance. Noting these characteristic lesions during a physical examination should alert a physician to the diagnosis of bulimia or to an exacerbation of symptoms in a patient whose condition was previously diagnosed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/18. Therapist's management of the replanted hand.The treatment of the patient with a replanted hand is a challenge to both the surgeon and the therapist. Because of multiple system involvement, we must be able to assess each structure individually to determine the best treatment protocol for that structure and then compile it into one treatment program. The communication among the triad of physician, therapist, and patient is the only way to guarantee successful results.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/18. Pediatric microsurgery: revascularization and replantation.Pediatric microvascular surgery has received little attention in the literature until recently. The demonstrated feasibility with successful results represents a disproportionately small patient population when compared with adults. One reason for this delayed growth in pediatric revascularization and replantation appears to be a lack of awareness on the part of both referring physicians and microvascular surgeons as to its present indications and outcome. Several cases are presented along with a review of the current literature to clarify this issue. A protocol for managing these patients from a triage standpoint is also included.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/18. Mechanical cornpicker hand injuries.The mechanical cornpicker causes tearing anse injuries from 1962 to 1975 were studied with regard to mechanism and extent ohe time of injury in 36% of hands, and in 73% of the remainder following treatmophylaxis, and antibiotics, and 73% hands required some form of delayed surgical treatment. Antibiotics did not appear to be helpful. Eighty-nine ps the most common cause given for farmers for their injuries. Excluding four pr permanently disabled patients, the average length of disability was 135 days. Eighty-nine per cent of patients experienced some permanent impairment of hand function. The mechanical cornpicker is described, and the importance of its proper use and physician's emphasis on accident prevention as well as treatment are stressed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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