Original Research Article
Year: 2023 | Month: January | Volume: 10 | Issue: 1 | Pages: 750-759
DOI: https://doi.org/10.52403/ijrr.20230187
Hand Injuries at Work: Causes, Spectrum and Management
Dr Junaid Khurshid1, Dr Umar Farooq Baba2, Haroon Rashid Zargar3, Dr Bashir Ahmad Bhat4
1Registrar, Plastic Surgery, Superspeciality Hospital Shireen Bagh, GMC Srinagar, India 190001
2Associate Professor, Plastic Surgery, SKIMS, India 190001
3Additional Professor, Plastic Surgery, SKIMS, India 190001
4Registrar, Plastic Surgery, Superspeciality Hospital Shireen Bagh, GMC Srinagar, India 190001
Corresponding Author: Dr. Bashir Ahmad Bhat
ABSTRACT
Background: Hand injuries are common and an increased surge has been seen secondary to the use of machines.The spectrum of injuries is wide ranging from injuries requiring few stitches to requiring specific reconstructive procedures such as skin grafting, pedicled flaps to free flaps or amputations depending on severity and pattern of injury.
Methods: This was a hospital-based single-arm prospective study conducted in the Department of Plastic and Reconstructive Surgery for 3 years. 46 patients were included.Each record was analyzed as per the etiology, the treatment received, the reconstructive procedures done, and the functional and aesthetic outcomes.
Results: Most of the affected individuals were young, the mean age of the patients was found to be 23 years. Among the injured 85% were males. The dominant hand (right hand) was more frequently injured in 74% of cases. In total 18 patients had some of the affected areas amputated; this included formalization of traumatic amputations. It is also significant that twelve patients underwent revascularization and four reimplantations. Twelve patients underwent groin flaps as a primary or delayed primary in the same admission. Ten patients required split skin grafting and three. Two patients were managed with FDMA flap for thumb defect, one patient was managed with reverse radial forearm flap for compound defect dorsum of thumb, and another with free lateral arm flap for compound defect of thumb.
Conclusion: The management of machine injuries of the upper limb and hand requires specific and unique methods of treatment. A "reconstructive ladder" of techniques was utilized, ranging from "simple" (e.g., direct closure, skin grafts, and local flaps) to "complex" (free flaps, toe-to-thumb transfer) procedures. The individual procedure selected is the most straightforward, consistent with expediency and early return of a functional hand. The return of these hands to function has been facilitated by recent advances in tissue assessment, free tissue transfer, and skilled hand therapy.
Keywords: Dominant hand, machine injury, band saw, brush cutter, rotator drill.
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