DEMOGRAPHIC, ANATOMICAL, AND CLINICAL FEATURES OF PATIENTS WITH GLASS-PUNCHING INJURIES

Öz

Objective: Glass-punching behavior may lead to simple injuries, or sometimes to permanent disabilities. The purpose of this study was to investigate the demographic, anatomical, and clinical features of patients presenting to the emergency department due to glass-punching, and to examine the relations between these factors.

Material and Methods: This retrospective study was performed with patients presenting to the emergency department due to glass-punching. Patients’ demographic data, where the incident took place, its cause, patient’s alcohol and substance use, history of psychiatric disease, the scale of the resulting injury, its location, whether it occurred in the flexor or extensor zones, accompanying injuries, and treatments administered were recorded. The chi-square test was used for data comparisons. p values <0.05 were regarded as significant.

Results: One hundred thirteen patents were included. Patients’ mean age was 25.39 ± 7.58 years and 88.5% were male. More than half of the patients (56.6%) were single, and 83.2% were injured on the right side. Alcohol consumption at time of injury was determined in 29.2%, and 12.4% of patients had a diagnosed psychiatric disease. The flexor zone 5 (33.6%) and zone 4 (18.6%), and the extensor aspect zone 5 (49.6%) and zone 6 (36.3%) were the most commonly injured regions. No correlation was determined between gender, marital status, or presence of psychiatric disease, and zone injuries (p>0.05). However, significant correlation was determined between extensor zone 4 injury and right-side injury, and alcohol use (p= 0.036; 0.014, respectively).

Conclusion: Glass-punching behavior is commonly seen in males, in single subjects, and in the right hand. The most commonly affected regions in such injuries are extensor zones-5 and 6, and flexor zones-4 and 5. Extensor zone-4 injury is more common in right-handed subjects and those using alcohol. 

Anahtar Kelimeler

• Keywords: Hand injury,glass-punching,tendon injury,trauma

Cama Yumruk Atan Hastaların Demografik, Anatomik ve Klinik Özellikleri

Öz

Amaç: Cama yumruk atmaya (CYA) davranışı, bazen basit yaralanmalara bazen de kalıcı sakatlıklara yol açar. Bu çalışmanın amacı, cama yumruk atma sonucu acil servise başvuran hastaların; demografik, anatomik ve klinik özelliklerini araştırmak ve bu faktörlerin birbiriyle olan ilişkisini incelemektir.

Gereç ve Yöntemler: Çalışma, acil servise cama yumruk atma nedeniyle başvuran hastalar üzerinde retrospektif olarak yapıldı. Hastaların demografik verileri, cama yumruk atma olayının gerçekleştiği yer, olay sebebi, olay tarihi, hastalardaki alkol ve madde kullanımı, psikiyatrik hastalık öyküsü, oluşan yaralanmanın boyutu, yeri, ekstansör ve fleksör zonda nerede bulunduğu, eşlik eden yaralanmalar ve tedaviler kaydedildi.  Verilerin karşılaştırılmasında ki-kare testi kullanıldı. p<0.05 anlamlı kabul edildi.

Bulgular: Çalışmaya 113 hasta dahil edildi. Hastaların, yaş ortalaması 25.39 ± 7.58 /yıl olup %88.5’i erkek ve %56.6’sı bekar ve %83.2’sinin de sağ taraf yaralanması mevcuttu. Yaralanma anında %29.2’sinde alkol tespit edilirken, %12.4’ünün tanısı konmuş psikiyatrik bir hastalığı bulunmaktaydı. Hastalarda, fleksör tarafta zon-5 (%33.6) ve zon-4 (%18.6), ekstansör tarafta ise zon-5 (%49.6) ve zon-6 (%36.3) en fazla yaralanan bölgelerdi. Cinsiyet, medeni hal ve psikiyatrik hastalığı olma ile zon yaralanmaları arasında ilişki saptanmadı (p>0.05). Ekstansör taraf zon-4 yaralanması ile sağ taraf yaralanması ve alkol kullananımı arasında anlamlı ilişki saptandı (sırasıyla, p= 0.036; 0.014).

Sonuç: Cama yumruk atma davranışı sıklıkla erkeklerde, bekârlarda ve sağ elde izlenmektedir. Bu tarz yaralanmalarda, ekstansör tarafta zon-5 ve 6, fleksör tarafta ise zon-4 ve 5 en fazla yaralanan bölgelerdir. Sağ elini kullananlarda ve alkol alanlarda ekstansör taraf zon-4 yaralanması daha sık izlenir.  

Anahtar Kelimeler

• El yaralanması,cama yumruk atma,tendon yaralanması,travma

Kaynakça

1. 1. 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):345-51.
2. 2. Trybus M, Tusinski M, Guzik P. Alcohol-related hand injuries. Injury. 2005;36(10):1237-40.
3. 3. Bokhari A, Stirrat A. The consequences of punching glass. J Hand Surg. 1997;22(2):202-3.
4. 4. Moeller FG, Barratt ES, Dougherty DM, Schmitz JM, Swann AC. Psychiatric aspects of impulsivity. Am J Psychiatry. 2001;158(11):1783-93.
5. 5. Bertelsen M, Jeppesen P, Petersen L, Thorup A, Le Quach P, Christensen TØ et al. Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial. Br J Psychiatry. 2007;191(51):140-6.
6. 6. Stenbacka M, Leifman A, Romelsjö A. Mortality and cause of death among 1705 illicit drug users: a 37 year follow up. Drug Alcohol Rev. 2010;29(1):21-7.
7. 7. Karger B, Niemeyer J, Brinkmann B. Suicides by sharp force: typical and atypical features. Int J Leg Med. 2000;113(5):259-62.
8. 8. Hayton M. Assessment of hand injuries. Curr Orthop. 2002;16(4):246-54.

9. 9. Gokhan S, Altunci YA, Orak M, Ustundağ M, Sogut O, Ozhasenekler A. Glass Related Hand and Wrist Injury: Accidental or Sudden Anger. Turk J Emerg Med. 2011;11(2):54-8.
10. 10. Kleinert HE, Schepel S, Gill T. Flexor tendon injuries. Surg Clin North Am. 1981;61(2):267-86.
11. 11. Verdan CE. Half a Century of Flexor-Tendon Surgery: Current status and changing philosophies. JBJS. 1972;54(3):472-91.
12. 12. Kleinert HE, Verdan C. Report of the committee on tendon injuries. J Hand Surg. 1983;8(5):794-8.
13. 13. Algül A, Ateş MA, Gülsün M, Doruk A, Semiz ÜB, Başoğlu C et al. Antisosyal kişilik bozukluğu olgularında kendini yaralama davranışının saldırganlık, çocukluk çağı travmaları ve dissosiyasyon ile ilişkisi. Anadolu Psikiyatri Dergisi. 2009;10:278-85.
14. 14. Ozen S, Subasi M, Yildirim A, Basturk M, Bez Y. Problem solving skills and childhood traumas in patients who self-injured by punching glass during an anger outburst. J Clin Exp Invest. 2010;1(1)25-30.
15. 15. Penn JV, Esposito CL, Schaeffer LE, Fritz GK, Spirito A. Suicide attempts and self-mutilative behavior in a juvenile correctional facility. J Am Acad Child Adolesc Psychiatry. 2003;42(7):762-9.
16. 16. Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G, Weinberg I, Gunderson JG. The 10‐year course of physically self‐destructive acts reported by borderline patients and axis II comparison subjects. Acta Psychiatr Scand. 2008;117(3):177-84.
17. 17. Keskin ED, Seckin U, Bodur H, Sevil A, Erdogan B, Akyuz M. Clinical Characteristics of Patients with Tendon Injuries. Turkish Journal of Physical Medicine and Rehabilitation. 2005;51(3):94-7.
18. 18. Altan L, Akin S, Bingol U, Ozbek S, Yurtkuran M. The prognostic value of the Hand Injury Severity Score in industrial hand injuries. Turk J Trauma Emerg Surg. 2004;10(2):97-101.
19. 19. Eroglu O, Kocak OM, Coskun F, Deniz T. Demographic Characteristics of Punching Glass Patients’ and Related to Weather Conditions. The Journal of Kırıkkale University, Faculty of Medicine. 2017;19(1):1-7.
20. 20. Michel SJ, Wang H, Selvarajah S, Canner JK, Murrill M, Chi A et al. Investigating the relationship between weather and violence in Baltimore, Maryland, USA. Injury. 2016;47(1):272-6.
21. 21. Anderson CA. Heat and violence. Curr Dir Psychol Sci. 2001;10(1):33-8.
22. 22. Iconomou TG, Zuker RM, Michelow BJ. Management of major penetrating glass injuries to the upper extremities in children and adolescents. Microsurgery. 1993;14(2):91-6.
23. 23. Sever C, Külahcı Y, Şahin C. Cama yumruk atmaya bağlı üst ekstremite hasarları. Selçuk Tıp Derg. 2012;28(2):95-7.
24. 24. Bunnell S. Hand Surgery: Presidential Address. JBJS. 1947;29(3):824-5.
25. 25. Şakrak T, Mangır S, Körmutlu A, Cemboluk Ö, Kıvanç Ö, Tekgöz A. 1205 El Yaralanmasi Olgusunun Retrospektif Analizi. Türk Plastik, Rekonstrüktif ve Estetik Cerrahi Dergisi. 2010;17(3):134-8.
26. 26. Clark D, Scott R, Anderson I. Hand problems in an accident and emergency department. J Hand Surg. 1985;10(3):297-9.
27. 27. Smith ME, Auchincloss J, Ali M. Causes and consequences of hand injury. J Hand Surg. 1985;10(3):288-92.
28. 28. Marston RA. Alcohol-related hand injuries: an unnecessary social and economic cost. Ann R Coll Surg Engl. 1992;74(5):312-313.
29. 29. Li G, Keyl PM, Smith GS, Baker SP. Alcohol and injury severity: reappraisal of the continuing controversy. J Trauma Acute Care Surg. 1997;42(3):562-9.
30. 30. Vinson DC, Mabe N, Leonard LL, Alexander J, Becker J, Boyer J, et al. Alcohol and injury. A case-crossover study. Arch Fam Med. 1995;4(6):505-11.
31. 31. Klonsky ED, Oltmanns TF, Turkheimer E. Deliberate self-harm in a nonclinical population: Prevalence and psychological correlates. Am J Psychiatry. 2003;160(8):1501-8.
32. 32. Ebrinç S BC, Semiz UB, Çetin M. Bedenine zarar veren sınır kişilik bozukluğu hastalarında dissosiasyon, hipnoz yatkınlık ve çocukluk çağı cinsel kötüye kullanımı. 3P dergisi. 2001;9:377-86.