Hand trauma: A prospective observational study reporting diagnostic concordance in emergency hand trauma which supports centralised service improvements

Review article: Best practice management of closed hand and wrist injuries in the emergency department (part 5 of the musculoskeletal injuries rapid review series)

“…Henry hypothesised that perhaps the broad spectrum of variation in fracture patterns and the many associated variables that are thought to affect treatment and outcome may prevent better quality studies such as RCTs from being performed . This may result in a gross underestimation of certain hand injuries, diagnostic error and poor management . Diagnostic errors in hand injuries have been the most common cause of successful litigious claims against EDs in the UK over the past 10 years .…”

“…66 This may result in a gross underestimation of certain hand injuries, diagnostic error and poor management. 1 Diagnostic errors in hand injuries have been the most common cause of successful litigious claims against EDs in the UK over the past 10 years. 68 Causes of diagnostic error included failure to correlate imaging with clinical findings.…”

“…Acute hand and wrist injuries are a frequent presentation to the ED, accounting for 10–30% of all presentations internationally and are among the top 20 most common ED presentations in Australia . These injuries are often caused by a fall‐on‐outstretched‐hand, sporting and occupational activities.…”

“…Appropriate management of acute hand and wrist injuries in the ED is critical, as mismanagement in the early phases of injury may result in long‐term disability, loss of work and/or income, reduced quality of life, psychological issues and withdrawal from society in extreme cases . The level of specialised training in the assessment of hand injuries is reported to influence diagnostic accuracy, which is important to consider in the ED setting when patients are assessed by various professions with varying levels of experience and at the time of maximal pain and swelling.…”

Incidence of Acute Trauma on Hand and Wrist: A Retrospective Study

“…These lesions are usually associated with nerve damage. This is usually due to the hand-inflicted mechanism of trauma (often a knife or glass) that contains many delicate anatomical structures in the vicinity (superficial and deep flexor tendons, Joint ligament, arteries, and nerves) 13 which are often not reported in the ICD-10 registry, so despite the effectiveness of the computerization of care, and the mandatory registration of ICD-10 to initiate care, many times the code may not correspond with actual patient injury.…”