Fractures and dislocation of the hand is a body injury involving complex structures and multiple functions, which frequently occur as they represent 10%-30% of all fractures. Such fractures and dislocation of the hand should be treated in the context of stability and flexibility; and tailored treatment is required in order to achieve the most optimal functional performance in each patient since deformation may occur if not treated, stiffness may occur with unnecessarily excessive treatment, and both deformation and stiffness may occur coincidently with inappropriate treatment. Stable injuries can be fixed with splintage whereas surgery is actively considered for unstable injuries. In addition, surgeons should keep in mind that as the surgical intervention is done aggressively, aggressive rehabilitation must be followed in correspondence with the surgical intervention. Successful outcome requires effort to prevent any potential complication including nerve hypersensitivity and infection. Finally, it is also important that the patient to know that swelling, stiffness, and pain may last for a long period of time until the recovery of fractures and dislocation of the hand.
Dislocations* ; Finger Injuries ; Hand* ; Humans ; Hypersensitivity ; Pliability ; Rehabilitation

BACKGROUND: Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effective method is functionally and aesthetically controversial. Despite some disadvantages, cross-finger pulp flap is a relatively simple procedure without significant complications or requiring special techniques. METHODS: This study included 90 patients with fingertip defects who underwent cross-finger pulp flap between September 1998 and March 2010. In 69 cases, neurorrhaphy was performed between the pulp branch from the proper digital nerve and the recipient's sensory nerve for good sensibility of the injured fingertip. In order to evaluate the outcome of our surgical method, we observed two-point discrimination in the early (3 months) and late (12 to 40 months) postoperative periods. RESULTS: Most of the cases had cosmetically and functionally acceptable outcomes. The average defect size was 1.7x1.5 cm. Sensory return began 3 months after flap application. The two-point discrimination was measured at 4.6 mm (range, 3 to 6 mm) in our method and 7.2 mm (range, 4 to 9 mm) in non-innervated cross-finger pulp flaps. CONCLUSIONS: The innervated cross-finger pulp flap is a safe and reliable procedure for lateral oblique, volar oblique, and transverse fingertip amputations. Our procedure is simple to perform under local anesthesia, and is able to provide both mechanical stability and sensory recovery. We recommend this method for reconstruction of fingertip injuries.
Amputation ; Anesthesia, Local ; Discrimination (Psychology) ; Finger Injuries ; Hand Injuries ; Humans ; Microsurgery ; Nerve Transfer ; Subcutaneous Tissue

OBJECTIVETo investigate the efficacy of buried purse-string suture in the treatment of mallet finger deformities.

METHODSFrom February 2009 to February 2010, 12 patients with closed non-fracture mallet fingers were treated by buried purse-string suture. The rupture tendons were sutured by purse-string suture with an atraumatic needle, and the knots were buried under subcutaneous tissue. External fixator was used at the extension position of the finger every night within three weeks after operation.

RESULTSAll patients were followed up for 6-12 months, mean 7 months. According to the Patel's evaluation criteria, 2 cases (17%) obtained excellent results, 7 good (58%), 2 fair (17%) and 1 poor (8%). The overall rate of the cases with excellent and good outcomes was 75%.

CONCLUSIONBuried purse-string suture is an easy and effective way to treat mallet finger deformities, with no serious postoperative complications or no need for reoperation.

PURPOSE: Electric saw is widely used and patients involved with the tool are increasing. We made efforts to analyze data of saw-related hand injuries. METHODS: Electric saw-related hand injuries that required operation were analyzed retrospectively by reviewing medical charts, clinical photographs and X-ray films from 2009 through 2013. Additionally, we interviewed patients regarding the type of electric saw involved (hand-held/table-mounted) and how the hand was injured. RESULTS: There were 16 male patients with 19 injured fingers and 22 injured tendons. Due to the damaging mechanism of the electric saw, injuries were severe and complex such as tendon, bone defects, fractures and amputations. 4 fingers had open fractures. Separately, 4 were amputated. Non-dominant hands were injured more by hand-held saw, while, dominant hands were damaged more by table-mounted saw. The thumb and index fingers were injured mostly by electric saw. Probability of dominant and non-dominant hand injury depends on the types of electric saw because of the working position when using this tool. CONCLUSION: Hand injuries can be classified according to the type of electronic saw used. Complete understanding of a specific trauma mechanism and the resulting injury patterns is important especially for hand surgeons. Surgeons should take into account the type of electric saw when examining patients. However, the most important step to prevent these types of injuries is to provide all workers with appropriate training and precautions before using the electric saw.
Amputation ; Finger Injuries ; Fingers ; Fractures, Open ; Hand Injuries* ; Hand* ; Humans ; Korea* ; Male ; Retrospective Studies ; Rupture ; Tendon Injuries ; Tendons ; Thumb ; X-Ray Film

The proximal phalangeal base is the most commonly fractured hand bone in children. Such fractures are rarely reported to be irreducible as a consequence of flexor tendon entrapment. A 12-year-old male sustained a malunited base fracture of the proximal phalanx of the small finger on the right hand and was unable to flex the finger. 6 weeks ago he was treated with closed reduction and percutaneous K-wire fixation, at another hospital. In a subsequent operation, it was found that the flexor tendon was entrapped at the fracture site. Flexor tenolysis and realignment of the fracture and internal fixation with K-wires were performed. The patient could perform his work without discomfort in his hand and a normal range of motion was possible in the small finger 12 months after the operation.
Child ; Epiphyses ; Finger Injuries ; Fingers ; Fractures, Malunited ; Hand ; Humans ; Male ; Reference Values ; Tendon Entrapment ; Tendons ; Trigger Finger Disorder

PURPOSE: Finger injury by green onion cutting machine is one of the common hand injuries in the kitchen. It has a unique feature: there are multiple parellel laceration 3 -5mm wide. There are two directions of injuries(vertical, oblique). It may involve bone, tendon, nerve, and vessel injuries. We discuss its management and the long -term progress. METHODS: We have treated six patients from 2003 to 2007. We carried out low tension approximation with thin suture materials to avoid ischemia and performed the additional operation as nail bed repair, tenorrhaphy, open reduction, vessel anastomosis, and composite graft. We reviewed the record of initial injury and collected the follow-up record. RESULTS: They were all middle aged - women who had worked in the kitchen. Right hand was dominent over left hand. The ratio of the directions was 3:3 (vertical:oblique). They were all competely healed although there were three atrophy, four hyperesthesia, and one nail deformity. CONCLUSION: Finger injury by green onion cutting machine is a unique pattern of laceration with various accompanied injuries. It may look like a severe form of injury, but in most cases have relatively favorable progress. We have to perform careful examination of accompanied injuries and carry out the proper management. First and foremost, the user especially in the middle aged women should be warned to be careful in handling this risky machine.
Atrophy ; Female ; Finger Injuries ; Fingers ; Follow-Up Studies ; Glycosaminoglycans ; Hand ; Hand Injuries ; Handling (Psychology) ; Humans ; Hyperesthesia ; Ischemia ; Lacerations ; Middle Aged ; Nails ; Onions ; Sutures ; Tendons ; Transplants

Finger injuries are becoming more common with the increasing use of mechanical industrial and household appliances. Among the hand injuries, amputation is the serious disaster to the patient. Recently, application of microsurgical technique to the reattachment of amputated digits has been common clinical procedures. We performed microsurgical replantation to the 75 patients with 102 digits from March in 1986 to February in 1988. The following results were obtained. 1. The most common age distribution was third decade and male to female ratio was about 5:1. 2. The ratio of right to left hand was about 1:1 but the dominant to non-dominant hand was about 2:1. 3. The index finger was most commonly injured and the next was middle finger. 4. The most common type of the injuries was the crushing injury and the most common vector was a kind of pressor. 5. The anesthesia was performed in equal ratio between the general and regional anesthesia. 6. The survival rate of micro-replantation to the injuries of the zone II was 77.8% and zone III was 80%. 7. The functional result after replantation at zone II was better than zone III. 8. Micro-replantation was performed in any case of the type of the injury, the severity of crushing and the ischemic time, and the patients requirement was an important factor.
Age Distribution ; Amputation* ; Anesthesia ; Anesthesia, Conduction ; Disasters ; Family Characteristics ; Female ; Finger Injuries ; Fingers ; Hand ; Hand Injuries ; Humans ; Male ; Replantation ; Survival Rate

Flexor tendon injuries of the “no man's land”(Zone2) in the hand have long been considered one of the problem areas for hand surgeons because of the frequently unsatisfactory result of treatment. Two-stage tendon reconstruction using the silicone rod prosthesis is one of the recent valuable procedures for management of severely damaged hand. From Aug. 1977 to Jun. 1978, the authors performed this procedure using “Hunter Silicone Rod” on 4 cases of flexor tendon injuries accompanied by deep cicatrix of soft tissue and stiffness of finger joints. The follow-up results were excellent in 3 cases out of the 4, and poor in the remaing case which had marked wound infection and stiffness of finger joints.
Cicatrix ; Finger Joint ; Follow-Up Studies ; Hand ; Prostheses and Implants ; Silicon ; Silicones ; Surgeons ; Tendon Injuries ; Tendons ; Wound Infection

No abstract available.
Hand Injuries* ; Hand*

No abstract available.
Hand Injuries* ; Hand*