Acute hand injury splinting – the good, the bad and the ugly

Abstract

Injuries to the hand comprise 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. The initial assessment and management of hand injuries is usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In the Department of Orthopaedic Hand Surgery, Morriston Hospital, we regularly observe patients presenting to the specialist hand fracture clinics having had initial management that shows no appreciation for the treatment objectives or the safe positions for splinting. This article aims to provide guidance for frontline staff on the management of hand fractures, with particular emphasis on the appropriate nonoperative care to avoid any unnecessary morbidity.

A Soft Pressure Sensor Skin to Predict Contact Pressure Limit Under Hand Orthosis

“…Patients must be over 18 years old and able to provide independent consent to join in the study. Five exclusion criteria were considered during the recruitment: (1) Patients with diabetes, paresthesia or sensation loss on hands; (2) Patients with open wounds on the hand, the wrist or the forearm of the affected side; (3) Patients with skin conditions, including blister, ulcer, rash, burn and other skin diseases on the hand, the wrist or the forearm of the affected side; (4) Patients with adhesive allergies; (5) Patients in whole day care or with mental illness or cognitive symptoms. Eligible patients were selected by clinicians and the researcher introduced the study when they came to the clinical room to have their orthoses customized.…”

“…1 shows another type of orthosis with thumb stabilization (WTS) in abduction, immobilizing the wrist in the same angle as WoTS, for conditions such as scaphoid fracture and first metacarpal base fracture. Poor patient adherence and reduced effectiveness of orthoses have been reported in clinics as contributing factors leading to more invasive surgical interventions [2]. As orthoses are required to be worn for a long period, discomfort and pressure sores [3] have become the main side effects due to excessive contact pressure.…”

Efficacy evaluation of closed reduction of fifth metacarpal neck fractures in children

“…В настоящее время при изолированных переломах пястных костей авторы [3,5,11] рекомендуют выполнять иммобилизацию «желобоватой» ульнарной или радиальной гипсовой лонгетой в «безопасном» положении кисти.…”

“…Степень угловой деформации для каждого перелома регистрировали по одному измерению на цифровых рентгенограммах, хранящихся в системе архивации и передачи радиологических изображений (Sectra PACS) Детской городской больницы № 22. Угловую деформацию измеряли 13,5 ± 0,47 (9)(10)(11)(12)(13)(14)(15)(16)(17) 14,4 ± 0,43 (12-17) Примечание. Данные представлены в виде среднего значения с 95 % доверительным интервалом.…”

Handverletzungen werden bei der klinischen Untersuchung oft nicht entdeckt

“…Dazu Tatsächlich sind aber Verletzungen an der Hand typischer Alltag in chirurgischen Notaufnahmenauch wenn es keine belastbaren Zahlen über die Inzidenz in Deutschland gibt. In der Literatur finden sich Angaben darüber, dass 11,6 -20 % aller Verletzungen, die in einer Notaufnahme behandelt werden, die Hand betreffen [4,5]. In Deutschland gibt es auch kein zentrales Register von Kliniken, die eine "rund-um-die-Uhr" Handchirurgie anbieten, wenn man einmal von den großen FESSH-Traumazentren absieht, die in Deutschland 43-mal vertreten sind.…”