题名

Analysis of Acute Hand Injury Victims Receiving Surgical Correction in a University Hospital

并列篇名

分析於某醫科大學附屬醫院接受手術矯正的急性手外傷患者

作者

Wu Hsiao Su(吳曉舒);Wu Chao Ming(吳兆明);Chen Chun Chia(陳俊嘉)

关键词

acute hand injury ; surgical correction ; causative factors ; mechanical forces ; wounds

期刊名称

臺灣整形外科醫學會雜誌

卷期/出版年月

33卷3期(2024 / 09 / 01)

页次

307 - 318

内容语文

英文;繁體中文

中文摘要

Background: Hand injuries are a common presentation in emergency departments, occurring in a variety of situations and leading to diverse outcomes. Following a hand injury, individuals often experience both functional and aesthetic compromises, even after appropriate management and repair. Salvage procedures may be unsuccessful, particularly when the initial trauma is severe. Regrettably, these traumatic forces were more prevalent in the industrial era than in the agricultural era. Aim and objectives: This study aimed to optimize the postoperative outcomes by analyzing the causes, affected anatomical regions, and injury characteristics associated with hand injuries. Material and methods: Between June 2019 and May 2022, 5,659 individuals with hand injuries sought treatment at our emergency department, of whom 521 underwent surgical correction by plastic surgeons. To optimize postoperative outcomes, we conducted a comprehensive review of medical records and photographic documentation of injured hands and analyzed the causative factors, affected anatomical regions, and injury characteristics. We utilize the Haddon Matrix to categorize personal and environmental attributes before, during and after the injury. This attributes are listed in a supplement table (attached). Results: Among the 521 patients who underwent surgical correction of acute hand injuries, 78% were males. Work-related hand injuries were the most common, accounting for 60.1% of cases. The left index finger was the most frequently injured digit (16.1%), while the right little finger sustained the least injuries (5.5%). Extensor tendon ruptures were predominantly caused by cutting injuries involving sharp blades. In the context of acute hand injuries, 34 cases involved metacarpal fractures, 19 of which resulted from traffic accidents. Among these 19 patients, 13 had right-hand injuries. A total of 138 individuals experienced fingertip or finger loss after injury. The most severe outcomes were observed in 66 patients who underwent degloving hand injuries (12.7%), even after salvage attempts. Conclusion: Despite adequate surgical salvage and correction of injured hands, varying degrees of functional and aesthetic impairment often persist, potentially leading to significant societal costs and self-esteem issues. The severity of hand injuries is directly correlated with the force applied to the affected area. Therefore, proactive measures should be taken to reduce both the force and opportunities for contact, to minimize the severity of these injuries.

英文摘要

背景:手部外傷是急診常見的傷害類型。它可能發生在任何情況下,並導致不同的後遺症。手部受傷後,即使經過適當的修復,受害者的手部功能和外形也會受到相當程度的損害。如果致傷的衝擊力量太猛烈,即使是及時的專業急救,也可能需要截肢。不幸的是,這些衝擊力量在工業時代比在農業時代更為強烈。目的及目標:本研究的目的是分析致傷原因、受影響的區域和損傷特徵以改善術後成效。材料及方法:2019年6月至2022年5月,5659名手外傷患者到我院急診科就診,521名患者在整形外科醫生的服務下接受了手術矯正。我們回顧了病歷記錄和受傷手的照片,以分析致傷因素、受影響的區域和受傷特徵。並模仿哈登矩證,列舉案主因素及可能改善的因子與適當的干預時機,列於補充資料。結果:在接受手術矯正的521名急性手外傷受害者中,78%為男性。工傷最常見,佔60.1%。最常受傷的手指是左手食指(16.1%),最少受傷的手指是右手小指(5.5%)。伸肌腱斷裂主要由鋒利的刀片割傷所致。急性手外傷掌骨骨折34例,車禍骨折19例。13人右手受傷。138人在受傷後失去指尖或手指。最嚴重的是脫手套型拉脫傷,佔66例(12.7%),甚至指頭截肢,即使盡快搶救的情況,搶救或重建效果都不好。結論:即使對手部損傷進行適當及時的手術搶救和矯正後,手部功能和外觀缺損仍會在一定程度上持續存在,並可能產生相當大的社會成本和自尊問題。手部受傷的嚴重程度與施加到接觸區域的力量成正比。為減少手部外傷的嚴重程度,應努力減少與外力不當接觸的機會。

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