Self-inflicted Hand Injuries: Diagnostic Challenge and Treatment

Friedman, Bezalel; Yaffe, Batia; Blankstein, Alexander; Rubinstein, Eitan; Rieck, Jonathan

doi:10.1097/00000637-198804000-00010

Cited by 28 publications

(18 citation statements)

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“…Moreover, factitious lesions place a burden on the healthcare system, because of the multiple treatment failures. They cause wastage of the medical team and expose these patients to unnecessary risks 9, 11…”

Section: Discussionmentioning

confidence: 99%

“…Searching for risk factors is important for the diagnosis. The main findings are a lack of objective history for the disorder, consultations with different physicians, use of a variety of medications (analgesics and psychotropics), psychiatric treatment, job-related problems, exaggeration of complaints and symptoms, and previous histories of abuse during childhood (social and physical), illness and family destructuring 2, 9, 12, 13. These are adults with unstable personal relationships and problems in social and work relationships 12 .…”

Section: Discussionmentioning

confidence: 99%

“…To make a correct diagnosis, it is essential that the medical team should maintain a high degree of suspicion 14 . Lesions and wounds showing the shape of objects, presence of foreign bodies in subcutaneous tissues, cuts, edema, cord marks and, especially, lesions that do not respond to conventional treatment are all forms of presentation of this pathological condition 2, 9, 10, 14, 15. The forms of the lesions and the means through which they are caused vary in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Factitious lesions of the hand

Oliveira

Bayer

Lauxen

et al. 2013

Revista Brasileira de Ortopedia (English Edition)

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Objective The presence of a lesion with atypical presentation, obscure clinical history, which does not improve with classic treatments, shall raise the red flag of the medical team. In such cases, the hypothesis of a factitious lesion shall be considered. Many times the correct diagnosis on the initial assessment may avoid high-cost diagnostic tests, unnecessary treatments, and time consumption of the medical team. We present here two classic cases of factitious lesions that, similar to those described in the literature, is difficult to diagnose and difficult to treat.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factitious lesions of the hand

Oliveira

Bayer

Lauxen

et al. 2013

Revista Brasileira de Ortopedia (English Edition)

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“…Zusammen mit einer Psychotherapie kann so die Chance eines chirurgischen Therapieerfolgs erhöht werden [15,16]. Eine Therapieform, die sich in mehreren Studien als wirksam erwiesen hat ist die dialektisch-behaviorale Therapie (DBT) nach Linehan, wie sie auch in der kooperierenden Klinik für Psychiatrie und Psychotherapie etabliert ist.…”

Section: Diskussionunclassified

Selbstverletzungen bei Menschen mit Borderline-Persönlichkeitsstörung

Stang

Rudolf

Siemers

et al. 2010

Chirurg

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One symptom of Borderline personality disorder is self inflicting behavior, especially cuts and thermal injuries in the upper extremity. Due to the complex underlying psychiatric disease, surgical treatment of these injuries can be tedious and frustrating; therefore it is sometimes necessary to differ from classical plastic surgery principals and to favorite a more conservative approach. In every case, close cooperation with psychiatrist is inalienable.

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“…Die Wundheilungsstörungen erscheinen logisch erklärbar und werden teilweise der mangelhaften Therapie des vorbehandelnden Kollegen angelastet. Die ständige Tendenz zur Abheilung zwingt den Patienten dazu, ständig frische Läsionen hinzuzufügen, und oft entstehen diese in kürzester Zeit [2]. Die Wunden liegen in vom Patienten leicht zu erreichenden Körperregionen und sparen den dominanten Arm oft aus [5].…”

Section: Symptomatikunclassified

Die Artefaktkrankheit in der plastischen Chirurgie

Frerichs

Fansa

Schneider

1998

Chirurg

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The therapy of factitious disorders is a challenge for the treating surgeon. Only a clear understanding of the underlying causes and a good doctor-patient relationship make a successful outcome possible. Discussion about a confrontation of the patient with the diagnosis and the best made of treatment is still in progress. Early diagnosis and the cooperation between surgeons and psychiatrists are the most important parts of dealing with factitious disorders. This article gives an overview of symptoms and therapies. Six case reports demonstrate possibilities of the disorder's appearance.

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Self-inflicted Hand Injuries: Diagnostic Challenge and Treatment

Cited by 28 publications

References 0 publications

Factitious lesions of the hand

Factitious lesions of the hand

Selbstverletzungen bei Menschen mit Borderline-Persönlichkeitsstörung

Die Artefaktkrankheit in der plastischen Chirurgie

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