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Extra-anatomic arch reconstruction can be performed safely and appears to be durable over long term follow-up. Its use with endovascular grafting should provide a durable reconstruction for patients who require aortic "debranching" prior endovascular thoracic aortic aneurysm repair.

Introduction:The hand of a Man is his most prized possession, and any injury to it has the potential to produce significant and permanent impairment to hand functions and that in turn can cause mental and financial burden. Hand injuries are very common in present world mainly due to industrialization. Studies conducted show that hand injuries presenting in a tertiary care centre constitute approximately 10% of all the trauma cases and present from simple lacerations and contusions to crush injuries and amputations; requiring timely and skillful management to improve the prognosis. Aim:The aim of this study is to evaluate the epidemiology of hand injuries and understand relation between mechanism of injury and prognosis and to study the Socio-economic impact. This study will provide us with better understanding of the various etiological factors for hand injuries and will help us to develop preventive and therapeutic measures for the same. Methods:This study was conducted among 200 patients presenting with hand injuries, in the OPD and CASUALTY of our hospital over a period of two year from January 2015 to December 2016. 1.4 Results: Males (88%) are affected more as compared to females (12%). The commonest age group affected was 25-35 years (36%) followed by 15-25 years (28%). The commonest contributing factor was machine injury (52.5%) followed by road traffic accidents (25%) and assault (13.5%) respectively. The index (26%) and middle (24%) fingers were involved more commonly. 1.5 Conclusions: Hand injuries are more common in an adult male working in industries who required to operate complex machinery followed by Road Traffic Accidents. Keywords: Hand injury, epidemiology, machine injury IntroductionThe Hand is identified throughout history of mankind as an important component of one's anatomy. The human hand is extremely complex and thus difficult to understand. Studies conducted show that hand injuries presenting in a tertiary care centre constitute approximately 10% of all the trauma cases and present from simple lacerations and contusions to crush injuries and amputation