Retrospective Evaluation of Patients with Traumatic Hand Injuries

Yıl 2023, , 171 - 176, 04.10.2023

Serkan Kablanoğlu , Bülent Alyanak , Ilgın Sade , Burak Çetinkaya , Sibel Balcı , Çiğdem Çekmece

https://doi.org/10.30934/kusbed.1327034

Öz

Objective: This study aimed to retrospectively examine the demographic, etiologic, and clinical characteristics of patients with traumatic hand-wrist injuries and to profile patients with the goal of contributing to preventive measures and protective programs.

Methods: The records of 225 patients who came to the Hand Rehabilitation Unit of our clinic with a traumatic hand injury in the last 5 years were reviewed retrospectively. Many parameters were recorded, including demographic characteristics such as age, sex, and occupation, as well as information about the injured hand, dominant hand, type of injury, injured tendon and zone, number of affected fingers, and associated structures.

Results: The study included 225 patients. Tendon injuries occurred most frequently in the 3rd decade. Of the injuries, 31.1% were caused by occupational accidents and 55.1% occurred in the dominant hand. Of the tendon injuries, 64% were flexor tendon injuries and 32.4% were extensor tendon injuries. Extensor Digitorum Communis (EDC)-3 tendons were involved in 11.6% of extensor tendon injuries, and Flexor Digitorum Superficialis (FDS)-4/Flexor Digitorum Profundus (FDP)-5 tendons were involved in 18.2% of flexor tendon injuries. In nerve injuries, median and ulnar nerves were equally affected (14.2%).

Conclusion: Tendon injuries primarily affect young male workers, resulting in significant disability and an inability to work. Epidemiologic data can expand our knowledge about injury patterns. Occupational training and the prevention of occupational accidents can help patients improve their functional capacity and minimize their economic burden.

Anahtar Kelimeler

hand, trauma, tendon, injury, retrospective

Kaynakça

• Sade I, İnanir M, Şen S, et al. Rehabilitation outcomes in patients with early and two-stage reconstruction of flexor tendon injuries. J Phys Ther Sci. 2016;28(8):2214-2219. doi:10.1589/jpts.28.2214
• Ergüner H, İnanır M, Dursun N, Dursun E. Travmatik el yaralanmalı hastalarımızın klinik özellikleri. Romatol Tıp Rehab. 2002;13(4):243-251.
• Gaul JS Jr. Identifiable costs and tangible benefits resulting from the treatment of acute injuries of the hand. J Hand Surg Am. 1987;12(5 Pt 2):966-970. doi:10.1016/s0363-5023(87)80266-6
• Burke FD, Dias JJ, Lunn PG, Bradley M. Providing care for hand disorders: trauma and elective. The Derby Hand Unit experience (1989-1990). J Hand Surg Br. 1991;16(1):13-18. doi:10.1016/0266-7681(91)90119-9
• Trybus M, Lorkowski J, Brongel L, Hladki W. Causes and consequences of hand injuries. Am J Surg. 2006;192(1):52-57. doi:10.1016/j.amjsurg.2005.10.055
• de Putter CE, Selles RW, Haagsma JA, et al. Health-related quality of life after upper extremity injuries and predictors for suboptimal outcome. Injury. 2014;45(11):1752-1758. doi:10.1016/j.injury.2014.07.016
• Zárate-Ramírez JG, Espinosa-Gutiérrez A. ¿Cuánto valen las lesiones de la mano? [How much are hand injuries worth?]. Acta Ortop Mex. 2013;27(5):345-349.
• Ootes D, Lambers KT, Ring DC. The epidemiology of upper extremity injuries presenting to the emergency department in the United States. Hand (N Y). 2012;7(1):18-22. doi:10.1007/s11552-011-9383-z
• Grivna M, Eid HO, Abu-Zidan FM. Epidemiology of isolated hand injuries in the United Arab Emirates. World J Orthop. 2016;7(9):570-576. doi:10.5312/wjo.v7.i9.570
• Angermann P, Lohmann M. Injuries to the hand and wrist. A study of 50,272 injuries. J Hand Surg Br. 1993;18(5):642-644. doi:10.1016/0266-7681(93)90024-a
• Keskin E, Seçkin Ü, Bodur H, Sevil A, Erdoğan B, Akyüz M. Tendon yaralanmalı hastalarımızın klinik özellikleri. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2005;51(3):94-97.
• Sanal H. El ve el bileği kemik doku yaralanmaları: nedenler, işgücü kaybı. Gülhane Tıp Dergisi. 2006;48(4):215-217.
• Tuncalı D, Toksoy K, Terzioğlu A, Aslan G. Üst ekstremite akut tendon yaralanmaları: Epidemiyolojik değerlendirme. 2005;13(2):114-118.
• de Putter CE, Selles RW, Polinder S, Panneman MJ, Hovius SE, van Beeck EF. Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study. J Bone Joint Surg Am. 2012;94(9):e56. doi:10.2106/JBJS.K.00561
• Davas Aksan A, Durusoy R, Ada S, Kayalar M, Aksu F, Bal E. Epidemiology of injuries treated at a hand and microsurgery hospital. Acta Orthop Traumatol Turc. 2010;44(5):352-360. doi:10.3944/AOTT.2010.2372
• Hey HW, Seet CM. Hand injuries seen at an emergency department in Singapore. Eur J Emerg Med. 2010;17(6):343-345. doi:10.1097/MEJ.0b013e32833777c4
• Campbell AS. Hand injuries at leisure. J Hand Surg Br. 1985;10(3):300-302. doi:10.1016/s0266-7681(85)80048-6
• Sorock GS, Lombardi DA, Hauser RB, Eisen EA, Herrick RF, Mittleman MA. Acute traumatic occupational hand injuries: type, location, and severity. J Occup Environ Med. 2002;44(4):345-351. doi:10.1097/00043764-200204000-00015
• Nieminen S, Nurmi M, Isberg U. Hand injuries in Finland. Scand J Plast Reconstr Surg. 1981;15(1):57-60. doi:10.3109/02844318109103413
• Karakurt Ü, Satar S, Açıkalın A, Gülen M, Bilen A, Baz Ü. Analysis of occupational accidents admitted to the emergency medicine department. Akademik Acil Tıp Dergisi. 2013;12(1):19-23.
• Altan L, Bingöl Ü, Selçuk A, Özkan N. The effect of sociodemographic characteristics and injury characteristics on rehabilitation outcomes of patients with hand injuries. Romatol Tıp Rehab. 2002;13(4):236-242.
• Beaton AA, Williams L, Moseley LG. Handedness and hand injuries. J Hand Surg Br. 1994;19(2):158-161. doi:10.1016/0266-7681(94)90154-6
• de Jong JP, Nguyen JT, Sonnema AJ, Nguyen EC, Amadio PC, Moran SL. The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study. Clin Orthop Surg. 2014;6(2):196-202. doi:10.4055/cios.2014.6.2.196
• Oleske DM, Hahn JJ. Work-related injuries of the hand: data from an occupational injury/illness surveillance system. J Community Health. 1992;17(4):205-219. doi:10.1007/BF01321653
• Brug E, Langer M, Probst A. Die Verletzungen der Beuge- und Strecksehnen im Handbereich [Flexor and extensor tendon injuries of the hand]. Orthopade. 2000;29(3):216-227.
• Crosby CA, Wehbé MA. Early protected motion after extensor tendon repair. J Hand Surg Am. 1999;24(5):1061-1070. doi:10.1053/jhsu.1999.1061
• Rosberg HE, Carlsson KS, Höjgård S, Lindgren B, Lundborg G, Dahlin LB. What determines the costs of repair and rehabilitation of flexor tendon injuries in zone II? A multiple regression analysis of data from southern Sweden. J Hand Surg Br. 2003;28(2):106-112. doi:10.1016/s0266-7681(02)00352-2
• Chang JH, Wu M, Lee CL, Guo YL, Chiu HY. Correlation of return to work outcomes and hand impairment measures among workers with traumatic hand injury. J Occup Rehabil. 2011;21(1):9-16. doi:10.1007/s10926-010-9246-4