Hand amputations: epidemiology, management and resurfacing options for soft tissue coverage

SUMMARY:Traumatic finger amputation is a widespread preventable public health problem. This study aimed to define the epidemiology of finger amputations to identify important related factors in order to suggest pertinent prevention strategies. A cross-sectional study was conducted in 2015 at the main orthopedic referral university hospital of Shiraz. All patients with any type of traumatic finger amputation were included. For each patient a questionnaire including demographic and injury characteristics was filled and analyzed. One hundred patients (92 men and 8 women, mean age: 32.5 ± 18 years) were enrolled. The vast majority of subjects were young men, more than half (53 cases) sustained occupation-related injuries during working time. Finger amputation following severe jammed finger in door was the second most frequent damage (18 %). Approximately 59% of victims labeled inattention during work as the reason of injury. Finger amputations in right hand were equal in frequency to the left one. Amputation of the index and middle fingers were seen as the most common amputated fingers in hands, 27% and 26% respectively. It was found that young beginner worker man with low educational level is at the highest risk of traumatic finger amputation especially with positive history of drug abusing. So, effective interventions such as closer supervision, more training programs, detection of drug addiction, and using safe engineering machines are urgently needed.

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“…This is in accordance with the other study shown an association of lower socioeconomic status with higher hand amputation (Khurram et al, 2015).…”

Section: Discussionsupporting

confidence: 94%

Epidemiological patterns and preventability of trauma leading to finger amputation

et al. 2017

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“…Several other machines are involved in upper extremities injuries such as grain augers, hay balers, power take-off, wheat threshers, and corn pickers. Often these injuries caused by these machines are mutilating and represent a real emergency, requiring major surgery [30,[63][64][65].…”

Section: Discussionmentioning

confidence: 99%

“…Three studies report that irrigation and surgical debridement are needed for most of the cases [28][29][30]. In Grandizio's study 2018 [28], patients with upper extremities injuries are more likely to require surgery and to be readmitted to hospital than those with other kind of lesions, especially with some risk factors for readmission such as age > 18 years, falls from height and surgery.…”

Section: Cross Articlesmentioning

confidence: 99%

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Upper Limb’s Injuries in Agriculture: A Systematic Review

Mucci

Traversini

Lulli

et al. 2020

IJERPH

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Agriculture is one of the most hazardous economic sectors, and it accounts for many accidents and occupational diseases every year. In Italy, about one-third of injuries involve the upper extremity, with long-term consequences for the workers and economic damage for agricultural companies and farms. This systematic review describes upper limb injuries among farmworkers, especially hand injuries, and highlights the main dangerous risk factors. Literature review included articles published in the major databases (PubMed, Cochrane Library, Scopus), using a combination of some relevant keywords. This online search yielded 951 references; after selection, the authors analyzed 53 articles (3 narrative reviews and 50 original articles). From this analysis, it appears that younger male farmers are mostly involved, especially in the harvesting season. The upper limb and hand are often the body parts that sustain most damage as these are mostly involved in driving tractors or tools. The most frequent type of lesions are open wounds, lacerations, fractures, strains, and overexertion lesions. Sometimes, a distracting element (such as mobile phone use, quarrels, working hours load) is present; poor use of protective devices and lack of safety design in tools can also increase the risk of accidents. For these reasons, in the agricultural sector, a system of health promotion and good practices is needed to promote workers’ awareness of the sources of risk, highlight more dangerous situations and apply organizational behavioral measures.

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“…Soft tissue defects on the hand require good flap cover for proper rehabilitation. There are a few types of flaps from the same forearm which could be used to cover the hand defects with the major advantage of a shorter hospital stay [6].…”

Section: Discussionmentioning

confidence: 99%

Reverse Posterior Interosseous Artery Flap: A Reliable, Comfortable and Versatile Flap for Coverage of Soft Tissue Defects of Hand

et al. 2020

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Background: Soft tissue defects of the hands require coverage with soft, pliable full-thickness skin. The posterior interosseous artery (PIA) flap fulfils all these requirements and also has significant advantages over other flaps; it is a single-stage procedure that does not sacrifice major vascular axis of the hand. However, the dissection can be challenging and requires meticulous skill. The objective of the study was to evaluate the reverse PIA flap for coverage of hand soft tissue defects in terms of its safety, reliability, comfort, function and aesthetic appearance.Methods: Over a period of 3 years, patients with soft tissue defects over the dorsum of the hand and first web space were observed. A standard PIA flap was raised using loupe magnification under general or brachial anesthesia. The size and location of the defect were noted along with the size and success of the flap.Results: Twelve patients, including nine males and three females, were taken up for this procedure. All the flaps survived completely except one with marginal necrosis not requiring a secondary procedure. All patients were quite satisfied with the procedure and went on to resume their work within a month or two.Conclusion: PIA flap is a safe, reliable option with great versatility for coverage of hand defects, especially over the dorsum. A well-planned flap surgery done under loupe magnification affords excellent results. The entire treatment also requires a shorter hospital stay and allows the patient to return to work quickly.

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Hand amputations: epidemiology, management and resurfacing options for soft tissue coverage

Cited by 6 publications

References 15 publications

Epidemiological patterns and preventability of trauma leading to finger amputation

Epidemiological patterns and preventability of trauma leading to finger amputation

Upper Limb’s Injuries in Agriculture: A Systematic Review

Reverse Posterior Interosseous Artery Flap: A Reliable, Comfortable and Versatile Flap for Coverage of Soft Tissue Defects of Hand

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