Epidemiology of Hand Injuries That Presented to the Emergency Department of a Tertiary Care Facility in Suburban Mumbai, India: A Study Including 489 Patients

Background: Hand injuries are very common and responsible for a significant number of emergency department (ED) visits, most of which are not to hand specialists [1]. The functionality and outcome of hand injuries can vary significantly depending on the mechanism and pattern of injuries, which is why it is imperative for emergency physicians to recognize the complexities, and the potential repercussion of missed injuries in such cases. Objective: The aim of this study is to provide epidemiological information on hand injuries and their patterns. The objective is 1) to assess whether most hand injuries are superficial (simple), or involve underlying deeper structures (complex) and 2) to assess whether most hand injuries presented to the emergency department were managed by the emergency physician or plastic/orthopaedic surgeon. Methods: This retrospective single-centre observational study conducted at an emergency department in a tertiary care hospital in Mumbai, India collected data from hand trauma patients using a standardized documentation form. Demographic data, trauma-related data, and disposition plans were analysed. Results: A total of 489 cases sustained hand injuries over a period of one year. The patients were predominantly males in the 20 - 30 year age group and injuries were mainly sustained over the right hand. Most of the injuries were sustained at home (42%). The most common mechanism (34%) was sharp object injury (including needle-stick and other sharps in hospital), followed by blunt injury (30%). Among grievous hand injuries, door jamb was a mechanism noted in 11% of patients, accounting for 50% of all crush injuries. Lacerations were the most common pattern (24.7%) noticed, followed closely by fractures (23.3%). Digits II - IV were injured most commonly (54%), followed by carpals (14%) and the thumb (10%). Nearly 80% of the hand injuries were managed by emergency physicians alone, with 61% of cases involving superficial structures. Though 14% of the cases required plastic surgery intervention, the initial evaluation of all these patients was performed by the emergency physician. Conclusions: Our study highlights the burden of hand injuries on the emergency physician, as well as the odds of missed injuries, directly indicating the necessity of a thorough anatomical knowledge of the structures of the hand, and in turn, a proper physical examination. A dedicated registry for hand trauma would help quantify the mechanism and pattern of injuries, and formulate preventive strategies.

Recent Hand Injuries: Epidemiological and Lesional Aspects (About 291 Cases)

Introduction: Hand injuries are frequent and serious. Their consequences, sometimes irreversible, are the cause of major handicaps. The aim of our work was to describe the epidemiological and lesional aspects of hand trauma in the Orthopedics-Traumatology department of the CHU Aristide Le DANTEC. Material and Method: This was a continuous retrospective study over a period of 2 years. From June 1, 2015, to December 31, 2016, concerning all patients who came for a trauma recent hand, followed and whose file was found and completed. Results: Of 351 patients, we retained 291, 247 men for 44 women, aged in average age of 34 and carrying out different activities with a predominance of workers manuals (78.01%). Most of them came from the Dakar region (75.26%). THE work accidents predominated with 47.08%. The involvement of the right side was 58.76% of cases and concerned the dominant side in 56.35%. On the lesion level, there were 36.4% osteo-articular lesions, 30.58% lesions of the parts soft, 23% nail lesions and 9.9% complex lesions associating at least 3 lesions elementary. Conclusion: Recent hand injuries account for 13.49% of injuries in our service;they are severe, affecting the different structures of the hand, either singly or jointly. They involve the functional prognosis of the hand with socio-professional repercussions important.

Evaluation of the Local Epinephrine Anesthesia without Tourniquet in the Surgical Treatment of Hand Injuries in Adults: About 27 Cases in Sub-Saharan Africa

Background: In sub-Saharan Africa, surgery for hand injuries is usually performed under axillary or general anesthesia. This is often not without consequences. The Wide Awake Local Anesthesia No Tourniquet (WALANT) is, therefore, an anesthetic asset in the surgical treatment of hand injuries. This study aims to share an experience on this technique’s effectiveness and to spark interest among African authors and practitioners. Method: This prospective study focuses on 27 surgeries of hand injuries carried out with WALANT. The study spanned over nine months (November 2021-August 2022) and included 19 men and eight women with a mean age of 35.4 years (extremes: 19 and 54). There were five (18%) flexor tendon ruptures, three of which were in zone 2, eleven (41%) metacarpal fractures, four of which were open, seven (26%) phalangeal fractures, two of which were open, and four (15%) finger springs. The operated lesions were assessed at a minimum of three months. The pain was assessed using the Visual Analog Scale. The QuickDASH score was evaluated for each patient at the end of the follow-up period. Results: Intra-operatively, the mean value of the Visual Analog Scale was 1/10, with extreme values of 1/10 and 3/10. Of the five cases of flexor tendon ruptures, three were located in zone 2 and two in zone 3. The metacarpal fractures were divided into seven closed diaphyseal fractures and four extra-articular metaphyseal fractures. Four of the seven phalangeal fractures were oblique diaphyseal, and three were transverse diaphyseal. The treatment of the protruding fingers followed the conventional technique. The assessment of the QuickDASH score in the months following surgery showed a score of 11.8 in the first month, 10.3 in the second month, and 5.0 in the third month. Conclusion: WALANT is an easy-to-use, unexpensive anesthetic technique that enables shorter operating times. It rarely presents complications. It is recommended for hand surgeries performed with limited technical resources.

Hand In Hand联合教学法在生物化学教学中的应用

目的:探讨Hand In Hand联合教学法在生物化学教学中的应用效果。方法:选取医学检验专业两个班,随机分为实验组和对照组,分别采用Hand In Hand联合教学法和传统教学法授课,通过考试和调查问卷评价教学效果。结果:实验组成绩明显高于对照组(P<0.01);实验组学生的学习主动性、分析问题、解决问题等能力显著提高(P<0.05)。结论:Hand In Hand联合教学法在生物化学教学中效果良好。

Hand in Hand East and West to Build a Glorious Gansu——Talk on the cooperation between the East and West of China by Mr.Cui Zhenghua,vice governor of Gansu Province

To implement the CPC CentralCommittee’s strategy of slanting theeconomic construction to the Midand West of China and to further promote thedevelopment and cooperation of economyand trade between the East and West, theEast-West Business and Trade Talks wereheld by the China Council for the Promotionof International Trade (CCPIT). At theconference, Mr. Cui Zhenghua, vice governorof Gansu Province and concurrently chairmanof the Gansu Subcouncil of the CCPIT,delivered a speech on the economiccooperation and development between theEast and West of China.

Chinese and American Students, Hand in Hand

IT was midsummer when Beijing International Airport received a group of 500 young guests - a delegation of college students from California, USA. They came for the "New Century, Silk Road" activity. In the following two days, they not only visited the Beijing University of Traditional Chinese Medicine and the China Millennium Monument, but also got together with 500 of their Chinese counterparts at the China Millennium Monument southern square. During their visit to world famous Tsinghua University, American students talked animatedly with contemporaries and teachers.

Hand in Hand——Chairman Leqoi Visits California

Nurtured by the moist winds of the Pacific Ocean, California is a beautiful American state. Among its famous cities, San Francisco is the one "most favored by Americans".On May 28, a group of Tibetan government officials and entrepreneurs arrived in San Francisco at the start of a 10-day-long friendship visit to the city and the state at large.Meeting Mayor BrownAccompanied by Wang Yunxiang, Chinese Consul General in San Francisco, the Tibetan delegation, led by Leqoi, Chairman of the

Epidemiology of isolated hand injuries in the United Arab Emirates

AIM To provide suggestions for hand injury prevention by study the demography and risk factors of casualties suffering from isolated hand injuries.METHODS All trauma patients with isolated hand injuries who were admitted to Al Ain Hospital for more than 24 h during a period of 3 years were studied. Patient demographics,location, mechanism/time of injury, and length of hospital stay were all analyzed.RESULTS Two hundred and ten patients were studied. Their mean age was 29.7 years. Males constituted 92%. Sixty-five point one percent of all cases were from the Indian subcontinent. The workplace was the most common location of injury(67.1%), followed by the home(17.1%)and road(6.2%). Machinery caused 36.2% of all injuries,followed by heavy object(20.5%) and fall(11%). Cases injured at home were young(P < 0.0001) with an associated higher incidence of females(P < 0.0001).CONCLUSION Male workers in Al Ain city are at greater risk of sustaining hand injuries, predominantly from machinery. Safety education, personal protection, and the enforcement of safety standards are essential to the prevention and avoidance of hand injury.

Bilateral Pedicled Superficial Epigastric Flap in the Management of Circumferential Combined Degloving and Full Thickness Burn Hand Injury—A Case Report

We report a case of combined hand trauma in the form of circumferential degloving injury of the hand with full thickness friction burns of the hand, forearm and the distal part of the upper arm. On exploration the hand was found avascular with loss of vital structures and full thickness burns. As a salvage procedure the hand was embedded in the subcutaneous tissue of the abdomen for 4 weeks and after that elevated as an inferiorly based flap on the bilateral superficial inferior epigastric arteries. Two weeks later the hand was freed by division of the base of the flap bilaterally. The details and description of the injury, the procedure and the outcome are discussed.

HAND IN HAND FOR THE MUTUAL FUTURE

Zhengzhou Yufa (Group) Co., Ltd., the largest white corundum manufacturer in China, the enterprise drafting and revising the national standard of white fused alumina abrasive GB/T 2479-2008, one of top 10 corundum manufacturer in Chinese abrasives industry, has been entitled as'Outstanding Refractories Enterprise in Henan,''TheQuality Credible Enterprise in Henan','Henan Model Enter-prise with Excellent Quality and Excellent Credit', and has passed ISO 9001 Quality Management System Certification. A province level enterprise technology center has been built in Yu fa Group.

HAND IN HAND FOR THE MUTUAL FUTURE Yufa Group

Zhengzhou Yufa(Group)Co.,Ltd.,the largest white corundum manufacturer in China,the enterprise drafting and revising the national standard of white fused alumina abrasive GB/T 2479-2008,one of top 10 corundum manufacturer in Chinese abrasives industry,has been entitled as'Outstanding Refractories Enterprise in Henan','

Epidemiology and Sequelae of Workplace Hand Injuries at a Tertiary Trauma Care Centre

Aims & Objectives: To study the epidemiology of workplace hand injuries, to understand relation between mode of injury and prognosis, to investigate into the possible contributing factors and to study the Socio-economic impact. Design of Study: For the prospective study there were 2 sources of data: 1) Proforma which was filled by the hand surgeon and 2) A questionnaire that was filled up by safety officer. For the retrospective study case, sheets were retrieved from the Medical Records section and a telephonic or personal interview was carried out by a single interviewer. Setting: Department of Plastic and Reconstructive Surgery, Parvathy Hospital, Chennai, India. Patients: A total of 419 industrial injury patients treated from January 2008 to January 2013 were included in the study. Further follow-up regarding return to work and residual disability continues. Main Outcome Measures: Personal details (Age, Gender, Handedness, Work experience, Income). Type of injury, mode of injury, day and time of injury, treatment given, disability and number of working days lost were measured. Results: Those workers who were experienced less than 6 months had more workplace injuries and the commonest contributing factor was co-workers carelessness followed by long working hours and faulty machinery. Maximum injuries occurred on Monday and morning shift. Conclusions: Constant supervision of trainees for 2 years, shorter working hours with regular breaks, regular health checkups for personnel, regular servicing of machines can prevent occurrence of hand injuries. Corrective surgery within 6 hours, systematic and protocol based physiotherapy and rehabilitation can reduce the economic loss and disability arising out of work place injuries.

Epidemiology of work-related hand and wrist injuries in a referral center: A descriptive study

BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.

Dynamic Hand Gesture-Based Person Identification Using Leap Motion and Machine Learning Approaches

Person identification is one of the most vital tasks for network security. People are more concerned about theirsecurity due to traditional passwords becoming weaker or leaking in various attacks. In recent decades, fingerprintsand faces have been widely used for person identification, which has the risk of information leakage as a resultof reproducing fingers or faces by taking a snapshot. Recently, people have focused on creating an identifiablepattern, which will not be reproducible falsely by capturing psychological and behavioral information of a personusing vision and sensor-based techniques. In existing studies, most of the researchers used very complex patternsin this direction, which need special training and attention to remember the patterns and failed to capturethe psychological and behavioral information of a person properly. To overcome these problems, this researchdevised a novel dynamic hand gesture-based person identification system using a Leap Motion sensor. Thisstudy developed two hand gesture-based pattern datasets for performing the experiments, which contained morethan 500 samples, collected from 25 subjects. Various static and dynamic features were extracted from the handgeometry. Randomforest was used to measure feature importance using the Gini Index. Finally, the support vectormachinewas implemented for person identification and evaluate its performance using identification accuracy. Theexperimental results showed that the proposed system produced an identification accuracy of 99.8% for arbitraryhand gesture-based patterns and 99.6% for the same dynamic hand gesture-based patterns. This result indicatedthat the proposed system can be used for person identification in the field of security.

Japanese Sign Language Recognition by Combining Joint Skeleton-Based Handcrafted and Pixel-Based Deep Learning Features with Machine Learning Classification

Sign language recognition is vital for enhancing communication accessibility among the Deaf and hard-of-hearing communities.In Japan,approximately 360,000 individualswith hearing and speech disabilities rely on Japanese Sign Language(JSL)for communication.However,existing JSL recognition systems have faced significant performance limitations due to inherent complexities.In response to these challenges,we present a novel JSL recognition system that employs a strategic fusion approach,combining joint skeleton-based handcrafted features and pixel-based deep learning features.Our system incorporates two distinct streams:the first stream extracts crucial handcrafted features,emphasizing the capture of hand and body movements within JSL gestures.Simultaneously,a deep learning-based transfer learning stream captures hierarchical representations of JSL gestures in the second stream.Then,we concatenated the critical information of the first stream and the hierarchy of the second stream features to produce the multiple levels of the fusion features,aiming to create a comprehensive representation of the JSL gestures.After reducing the dimensionality of the feature,a feature selection approach and a kernel-based support vector machine(SVM)were used for the classification.To assess the effectiveness of our approach,we conducted extensive experiments on our Lab JSL dataset and a publicly available Arabic sign language(ArSL)dataset.Our results unequivocally demonstrate that our fusion approach significantly enhances JSL recognition accuracy and robustness compared to individual feature sets or traditional recognition methods.

Surgical management of adult hand macrodactyly in a 49-year-old patient:A case report

BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.

Non-steroidal anti-inflammatory drugs in postoperative hand fracture management:Do they positively or negatively impact recovery?

This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.