Purpose: Pediatric hand trauma is common and sometimes causes deformity or disability. The incidence and etiologies of hand trauma in children are different from those in adults. This study analyzed the characteristics of pediatric hand trauma cases and patients over a 15-year period. Methods: We conducted a retrospective medical record review of 3,432 children (2,265 boys, 1,167 girls, under 18 years of age) with hand injuries from January 2005 to December 2019. We evaluated the sex distribution and injury etiologies. Injuries were classified by type as burns, amputations, crushing injuries, lacerations, extensor and flexor tendon injuries, open and closed fractures, and nerve injuries. Results: Among the pediatric hand injury patients, males were predominant (1.94:1). Simple lacerations (58.4%) were the most common injury type, followed by fractures (22.8%). Lacerations and burns tended to be common in younger age groups, while tendon injuries, nerve injuries, and crushing injuries were more frequently encountered in older age groups. Conclusions: Hand trauma prevention strategies should be established considering the frequent trauma etiologies in specific age groups. An awareness of age-specific characteristics of pediatric hand trauma patients will be helpful to prevent hand trauma.
Kim, Yong Hun;Choi, Jin-hee;Chung, Yoon Kyu;Kim, Sug Won;Kim, Jiye
Archives of Plastic Surgery
/
v.46
no.1
/
pp.63-68
/
2019
Background Hand injuries caused by chain saws, electric saws, and hand grinders range from simple lacerations to tendon injuries, fractures, and even amputations. This study aimed to understand the distribution of various types of hand and upper extremity injuries caused by power tools, in order to help prevent them, by investigating the incidence and cause of power tool injuries treated over a 4-year period at a single institution in Korea. Methods We reviewed the medical records of patients who visited a single institution for power tool-induced injuries from 2011 to 2014. The distribution of sex, age, injured body part, type of injury, and mechanism of injury sustained by patients who received hand and upper extremity injuries from using an engine saw, electric saw, or hand grinder was evaluated. Results Among 594 subjects who were injured by power tools, 261 cases were hand and upper extremity injuries. The average age was 53.2 years. Tendon injury was the most common type of injury. An electric saw was the most common type of power tool used. More injuries occurred in non-occupational settings than in occupational settings. Conclusions In this study, power tool-induced hand and upper extremity injuries were mostly caused by direct contact with electric saw blades. More injuries occurred due to non-occupational use of these tools, but the ratios of amputations and structural injuries were similar in the non-occupational and occupational groups.
Kim, Jin Sung;Sung, Seung Je;Kim, Young Joon;Choi, Young Woong
Archives of Plastic Surgery
/
v.44
no.2
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pp.144-149
/
2017
Background The purpose of this study was to identify the epidemiologic characteristics of hand tendon injuries in children and to compare these with those of adults. Methods This retrospective study was conducted on acute traumatic tendon injuries of the hand treated at our institution from 2005 to 2013, based on medical records and X-ray findings. Age, sex, hand injured, mechanism of injury, tendons and zones injured, number of affected digits, and comorbidities and complications were analyzed. Patients were divided into 2 groups: a pediatric group (${\leq}15years$) and an adult group (>15 years). Results Over the 9-year study period, 533 patients were surgically treated for acute traumatic tendon injuries of the hand. In the pediatric group (n=76), being male, the right hand, the extensor tendon, complete rupture, the middle finger, and glass injury predominated in hand tendon injuries. In the adult group (n=457), results were similar, but injury to the index finger and knife injury were the most common. An accompanying fracture was more common in the adult group and complication rates were non-significantly different. Conclusions This comparative analysis revealed no significant epidemiologic intergroup differences. The belief that pediatric tendon injuries tend to be less severe is misplaced, and careful physical examination and exploration should be conducted in pediatric cases of hand injury.
Jeon, Byung-Joon;Lee, Jung-Il;Roh, Si Young;Kim, Jin Soo;Lee, Dong Chul;Lee, Kyung Jin
Archives of Plastic Surgery
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v.43
no.1
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pp.71-76
/
2016
Background The purpose of this study was to identify comprehensive hand injury patterns in different pediatric age groups and to assess their risk factors. Methods This retrospective study was conducted among patients younger than 16-year-old who presented to the emergency room of a general hospital located in Gyeonggi-do, Republic of Korea, and were treated for an injury of the finger or hand from January 2010 to December 2014. The authors analyzed the medical records of 344 patients. Age was categorized according to five groups. Results A total of 391 injury sites of 344 patients were evaluated for this study. Overall and in each group, male patients were in the majority. With regard to dominant or non-dominant hand involvement, there were no significant differences. Door-related injuries were the most common cause in the age groups of 0 to 3, 4 to 6, and 7 to 9 years. Sport/recreational activities or physical conflict injuries were the most common cause in those aged 10 to 12 and 13 to 15. Amputation and crushing injury was the most common type in those aged 0 to 3 and 4 to 6 years. However, in those aged 10 to 12 and 13 to 15, deep laceration and closed fracture was the most common type. With increasing age, closed injuries tended to increase more sharply than open injuries, extensor tendon rupture more than flexor injuries, and the level of injury moved proximally. Conclusions This study provides a comprehensive overview of the epidemiology of hand injuries in the pediatric population.
Ricci, Joseph A.;Vargas, Christina R.;Ho, Olivia A.;Lin, Samuel J.;Lee, Bernard T.
Archives of Plastic Surgery
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v.46
no.3
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pp.198-203
/
2019
Background Professional affiliation between medical centers and professional sports teams can be mutually beneficial in the provision of healthcare and marketing strategy. Anecdotal evidence suggests a link between trauma volume and sporting events; however, there is limited data. This study aims to characterize the incidence of operative hand and facial trauma during professional baseball home games. Methods A retrospective review of surgical cases for traumatic hand or facial injuries at a level 1 center between 1999 and 2012 was performed. Demographic information including date of injury, admission status, and operative repair were collected. Patients were grouped based on whether their trauma occurred on the date of a home game. Results Operative hand and facial trauma occurred at a rate of 33.4 injuries per 100 days with home games, compared to 22.2 injuries per 100 days (incidence rate ratios, 1.50; 95% confidence interval, 1.34-1.69). When home games were played, patients were more likely to present as a result of motorcycle accidents (3.1% vs. 1.5%; P=0.04) or bicycle accidents (5.0% vs. 2.6%; P=0.01). Other mechanisms of trauma were not statistically different. There was an increase incidence of injuries during home games in August; weekly variability showed an increased incidence during the weekends. Conclusions There was an increased rate of operative hand and facial injuries on dates with professional home games. The incidence of injuries during home games was higher in the late summer and on the weekends. Further analysis may allow improved resource allocation and strategies for injury prevention and treatment.
Kim, Seong-Ki;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo
Archives of Plastic Surgery
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v.37
no.3
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pp.245-249
/
2010
Purpose: High-pressure injection injury is caused by accidental injection of the high-pressure injection devices in industry. The initial benign appearance of the wound fools patients into delays in an adequate treatment. And it can result in disastrous outcomes such as necrosis and amputation. To avoid the poor prognosis, the injuries require a prompt surgical intervention. The purpose of this article is to recognize the poor outcome of the highpressure injection injury and to introduce an adequate treatment in need. Methods: We have 4 cases of the high-pressure injection injuries in the hand from April, 2005 to March, 2009. Average age is 39 years (30 - 49 years old), 2 cases are the palm of dominant hand, 1 case is the thumb of dominant hand, and 1 case is the palm of non-dominant hand, respectively. We followed up these patients for 20 months on average. In 3 cases, the immediate, aggressive surgical intervention was carried out, but the other one was delayed in early adequate treatment. The wounds were covered by local advancement flap, anterolateral thigh free flap, conservative treatment with antibiotics and dressing. Results: No pathogens after culture were found nor any findings of fracture in imaging study. Conservative treatment, local advancement flap and anterolateral thigh free flap for the open wound resulted in a desirable aesthetic outcome. In a long-term follow up, functional capability of the patient was also satisfactory. Conclusion: Upon initial evaluation, most high-pressure injection injuries present as innocuous wounds with very few symptoms and result in delaying the proper management. And the majority of high-pressure injection injuries will produce significant morbidity to the hand, amputation. And the initial aggressive surgical debridement was needed to prevent the poor outcome. The key to success in treating high-pressure injection injuries of the hand is the prompt aggressive surgical intervention.
This study aims to argue fundamental issues on factors associated with revenues of hand injury patients to effectively manage hospitals specialized in hand injuries. The study employes 2,461 patients who entered S hospital from 2008 to 2010 with hand injuries. The followings are the results of the study. First, there is significant difference among occurrence of hand injuries with regard to demographics of patients. That is, it is likely to have longer average length of stay(ALOS) of male over female, of the elderly over infants and toddlers, and vice versa on average daily patient revenues. Also, compared to patients with traffic and labor insurance, patients with health insurance is likely to stay longer at lower daily cost. Fifth, demographics and incidence of hand injuries were significantly associated with average length of stay(ALOS) and average daily patient revenues. That is, male over female, age over 60 over any other age categories, patients with traffic and labor insurances over one with health insurance, cases with laceration, avulsion and bone transplantation over any other types of hand injury patients were factors significantly related to ALOS and average daily patient revenues. In sum, it is needed to focus on education and campaign to raise attentions on preventing various hand injuries. Also, managers at hospitals specialized in hand injuries should pay attention on issues such as reducing ALOS to run the organization effectively.
Purpose: With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center. Methods: Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments. Results: The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department. Conclusions: The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.
Objectives: The purpose of the study is to investigate the needlestick injuries in the dental hygienists. Methods: A self-reported questionnaire was completed by 253 dental hygienists by convenience sampling from December 1, 2014 to March 20, 2015. The questionnaire consisted of 11 questions of sociodemographic characteristics, 5 questions of needlestick injuries experience, 3 questions of needlestick injuries during treatment and 2 questions of needlestick handling method. Data were analyzed by chi-square test, t-test and one way ANOVA analysis using SPSS 18.0 statistical program. Results: Those who had needlestick injuries within a year were 150 persons (59.3%) and the mean was 1.28 times per year. The needlestick injuries were frequent in the local anesthetic injection to gum. The completion and removal of the needle injection by hand accidently stung the digits and hand (p<0.01). Conclusions: Needlestick injuries can happen at any time to the dental hygienists in the dental clinics, so it is necessary to handle the needlestick carefully in case of anesthetic injection.
Yim, Young Min;Oh, Deuk Young;Jung, Sung No;Rhie, Jong Won;Ahn, Sang Tae;Kwon, Ho
Archives of Plastic Surgery
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v.36
no.1
/
pp.46-50
/
2009
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 - 5 mm 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.
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