MEDLINE Abstracts: Injuries of the Wrist and Hand
MEDLINE Abstracts: Injuries of the Wrist and Hand
What types of injuries affect the wrist and hand? Find out in this easy-to-navigate collection of recent MEDLINE abstracts compiled by the editors at Medscape Orthopaedics & Sports Medicine.
Hill C, Riaz M, Mozzam A, Brennen MD
Journal of Hand Surgery - British Volume 23(2):196-200, 1998 Apr
This study reports the characteristics, causes and disposal of isolated injuries to the hand and wrist presenting to six accident and emergency departments over a period of 4 months. The rate of isolated injury to the hand or wrist was 6.6%. The male: female ratio was 2.2: 1, with the mean age for injury being 26.4 years in men and 29.2 years in women. The modal age group for injury was 21-25 years in men and 11-15 years in women. The right and left hand were injured almost equally. The dominant hand was more commonly injured although this was influenced by the cause of injury: 16.3% were caused by a fall; 15% by sport; and 7% were work/machinery related. 13.3% were referred to specialities for further treatment.
Robinovitch SN, Chiu J
Journal of Orthopaedic Research 16(3):309-13, 1998 May
Falls on the outstretched hand are among the most common causes of traumatic bone fracture. However, little is known regarding the biomechanical factors that affect the risk for injury during these events. In the present study, we explored how upper-extremity impact forces during forward falls are affected by modification of surface stiffness, an intervention applicable to high-risk environments such as nursing homes, playgrounds, and gymnasiums. Results from both experimental and linear biomechanical models suggest that during a fall onto an infinitely stiff surface, hand contact force is governed by a high-frequency transient (having an associated peak force Fmax1), followed by a low-frequency oscillation (having an associated lower magnitude peak force Fmax2). Practical decreases in surface stiffness attenuate Fmax1 but not Fmax2 or the magnitude of force transmitted to the shoulder. Model simulations reveal that this arises from the compliant surface's ability to decrease the velocity across the wrist damping elements at the moment of impact (which governs Fmax1) but inability to substantially reduce the peak deflection of the shoulder spring (which governs Fmax2). Comparison between model predictions and previous data on fracture force suggests that feasible compliant surface designs may prevent wrist injuries during falls from standing height or lower, because Fmax1 will be attenuated and Fmax2 will remain below injurious levels. However, such surfaces cannot prevent Fmax2 from exceeding injurious levels during falls from greater heights and therefore likely provide little protection against upper-extremity injuries in these cases.
Appleton DR
Journal of the Royal Society of Medicine 90(4):218-20, 1997 Apr
Of 214 croquet players who responded to a questionnaire, 76 reported at least one injury to hand, wrist or forearm caused by striking the ball. There was no obvious relation to which of the three main grips the player applied to the mallet. Injuries were somewhat more frequent when the mallet shaft consisted of fibreglass than when it was wood, metal or carbon fibre, but a causal relation has not been established. Back injuries seem less troublesome in croquet than in golf.
Verdon ME
Primary Care; Clinics in Office Practice 23(2):305-19, 1996 Jun
Overuse syndromes are one of the most common occupational illnesses treated by primary care providers. Their pathophysiology parallels that of tenosynovitis. Occupational risk factors for overuse syndromes include repetition, high force, awkward joint posture, direct pressure, and vibration. Initial treatment is aimed at preventing fibrosis through rest, immobilization, and anti-inflammatory agents. Treatment must include identification and adjustment of occupational risk factors. Specific overuse syndromes are discussed, including tenosynovitis of the dorsal wrist extensor compartments and flexor tendons of the wrist, trigger finger, and carpal tunnel syndrome.
Holtzhausen LM, Noakes TD
Clinical Journal of Sport Medicine 6(3):196-203, 1996 Jul
Objectives: Sport rock climbing with its repetitive high-torque movements in gaining the ascent of a rock face or wall, often in steep overhanging positions, is associated with a unique distribution and form of upper limb injuries. In this article, we review the biomechanical aspects of sport rock climbing and the types of injuries commonly encountered in the forearm, wrist, and hand regions of elite sport rock climbers. Because elbow, forearm, wrist, and hand injuries predominate, representing 62% of the total injuries encountered, these anatomical areas have been selected for review.
Data Sources: The predominant source of data are the published work of Bollen et al. The remaining sources were obtained through electronic search of the Medline and Current Contents Databases (last searched May 1995). German and French articles were included in the search criteria.
Study Selection: Only studies dealing with acute soft tissue and overuse injuries amongst sport rock climbers were selected.
Data Extraction: Data were extracted directly from the sourced articles.
Data Synthesis: The following injuries have been described in detail with regard to their presentation, diagnosis, treatment, and prevention amongst sport rock climbers: medial epicondylitis, brachialis tendonitis, biceps brachii tendonitis, ulnar collateral ligament sprain of the elbow, carpal tunnel syndrome, digital flexor tendon pulley sheath tears, interphalangeal joint effusions, fixed flexion deformities of the interphalangeal joints, and collateral ligament tears of the interphalangeal joints.
Conclusion: Many of the injuries are specific to the handhold types used by the rock climber. Accurate diagnosis and effective treatment of these unique injuries will be facilitated by a wider understanding of the biomechanical aspects of rock climbing and an awareness of the patterns and incidence of injuries in this sport.
Innis PC
Current Opinion in Pediatrics 7(1):83-7, 1995 Feb
Injury is our children's greatest health problem, and pediatricians will frequently see finger and hand injuries in the office and emergency room. Many of these will be fingertip crush injuries, which are quite common in toddlers and are often undertreated. Pediatric finger and wrist fractures and sprains generally do well but require proper diagnosis and treatment. Innocent-looking wounds from glass lacerations may disguise extensive damage to underlying nerves, arteries, and tendons. Advances in microsurgery allow replantation of distal amputations even in young children and infants, although often not without complications. Thermal injuries and animal bites require early and aggressive treatment. As with many pediatric hand injuries, these injuries should be preventable, and the adverse consequences can be minimized with appropriate diagnosis and management.
Huelke DF, Moore JL, Compton TW, Samuels J, Levine RS
Journal of Trauma 38(4):482-8, 1995 Apr
Objective: Details on airbag injuries to the upper extremity are relatively unknown to clinicians. The injuries presented here should provide a clear understanding of the mechanisms of forearm, hand, and wrist injuries that may be seen by emergency room physicians.
Materials and Methods: From our crash investigations of 325 airbag-equipped passenger cars, a subset of upper extremity injuries are presented that are related to airbag deployments.
Main Results: Minor hand, wrist, or forearm injuries--contusions, abrasions, and sprains--are not uncommonly reported. Infrequently, hand fractures have been sustained and, in isolated cases, fractures of the forearm bones or of the thumb, wrist, and fingers. The close proximity of the forearm to the airbag module door is related to most of the fractures identified. Steering wheel airbag deployments can fling the hand-forearm into the instrument panel, rearview mirror, or windshield, as indicated by contact scuffs, tissue debris, or the star burst (spider web) pattern of windshield breakage in front of the steering wheel.
Conclusion: Minor injuries of the upper extremity can occur when contacted by the deploying airbag either directly or by flinging the hand-forearm into interior car structures. Fractures of the forearm are rare and usually are due to direct impact by the forceful opening of the airbag module door.
Katarincic JA
Occupational Medicine 13(3):549-68, 1998 Jul-Sep
The hands are extremely vulnerable to injury because of their constant use. This chapter features analyses of the evaluation, treatment, rehabilitation, and complications of fractures of the distal radius, carpus, metacarpals, and phalanges.
Maupin BK
Occupational Medicine 13(3):533-47, 1998 Jul-Sep
Treatment of some complex disorders of the hand and wrist joints continues to challenge even the most experienced clinician. Dr. Maupin discusses both these injuries and the simpler ligament disorders that commonly result from everyday activities.
What types of injuries affect the wrist and hand? Find out in this easy-to-navigate collection of recent MEDLINE abstracts compiled by the editors at Medscape Orthopaedics & Sports Medicine.
Hill C, Riaz M, Mozzam A, Brennen MD
Journal of Hand Surgery - British Volume 23(2):196-200, 1998 Apr
This study reports the characteristics, causes and disposal of isolated injuries to the hand and wrist presenting to six accident and emergency departments over a period of 4 months. The rate of isolated injury to the hand or wrist was 6.6%. The male: female ratio was 2.2: 1, with the mean age for injury being 26.4 years in men and 29.2 years in women. The modal age group for injury was 21-25 years in men and 11-15 years in women. The right and left hand were injured almost equally. The dominant hand was more commonly injured although this was influenced by the cause of injury: 16.3% were caused by a fall; 15% by sport; and 7% were work/machinery related. 13.3% were referred to specialities for further treatment.
Robinovitch SN, Chiu J
Journal of Orthopaedic Research 16(3):309-13, 1998 May
Falls on the outstretched hand are among the most common causes of traumatic bone fracture. However, little is known regarding the biomechanical factors that affect the risk for injury during these events. In the present study, we explored how upper-extremity impact forces during forward falls are affected by modification of surface stiffness, an intervention applicable to high-risk environments such as nursing homes, playgrounds, and gymnasiums. Results from both experimental and linear biomechanical models suggest that during a fall onto an infinitely stiff surface, hand contact force is governed by a high-frequency transient (having an associated peak force Fmax1), followed by a low-frequency oscillation (having an associated lower magnitude peak force Fmax2). Practical decreases in surface stiffness attenuate Fmax1 but not Fmax2 or the magnitude of force transmitted to the shoulder. Model simulations reveal that this arises from the compliant surface's ability to decrease the velocity across the wrist damping elements at the moment of impact (which governs Fmax1) but inability to substantially reduce the peak deflection of the shoulder spring (which governs Fmax2). Comparison between model predictions and previous data on fracture force suggests that feasible compliant surface designs may prevent wrist injuries during falls from standing height or lower, because Fmax1 will be attenuated and Fmax2 will remain below injurious levels. However, such surfaces cannot prevent Fmax2 from exceeding injurious levels during falls from greater heights and therefore likely provide little protection against upper-extremity injuries in these cases.
Appleton DR
Journal of the Royal Society of Medicine 90(4):218-20, 1997 Apr
Of 214 croquet players who responded to a questionnaire, 76 reported at least one injury to hand, wrist or forearm caused by striking the ball. There was no obvious relation to which of the three main grips the player applied to the mallet. Injuries were somewhat more frequent when the mallet shaft consisted of fibreglass than when it was wood, metal or carbon fibre, but a causal relation has not been established. Back injuries seem less troublesome in croquet than in golf.
Verdon ME
Primary Care; Clinics in Office Practice 23(2):305-19, 1996 Jun
Overuse syndromes are one of the most common occupational illnesses treated by primary care providers. Their pathophysiology parallels that of tenosynovitis. Occupational risk factors for overuse syndromes include repetition, high force, awkward joint posture, direct pressure, and vibration. Initial treatment is aimed at preventing fibrosis through rest, immobilization, and anti-inflammatory agents. Treatment must include identification and adjustment of occupational risk factors. Specific overuse syndromes are discussed, including tenosynovitis of the dorsal wrist extensor compartments and flexor tendons of the wrist, trigger finger, and carpal tunnel syndrome.
Holtzhausen LM, Noakes TD
Clinical Journal of Sport Medicine 6(3):196-203, 1996 Jul
Objectives: Sport rock climbing with its repetitive high-torque movements in gaining the ascent of a rock face or wall, often in steep overhanging positions, is associated with a unique distribution and form of upper limb injuries. In this article, we review the biomechanical aspects of sport rock climbing and the types of injuries commonly encountered in the forearm, wrist, and hand regions of elite sport rock climbers. Because elbow, forearm, wrist, and hand injuries predominate, representing 62% of the total injuries encountered, these anatomical areas have been selected for review.
Data Sources: The predominant source of data are the published work of Bollen et al. The remaining sources were obtained through electronic search of the Medline and Current Contents Databases (last searched May 1995). German and French articles were included in the search criteria.
Study Selection: Only studies dealing with acute soft tissue and overuse injuries amongst sport rock climbers were selected.
Data Extraction: Data were extracted directly from the sourced articles.
Data Synthesis: The following injuries have been described in detail with regard to their presentation, diagnosis, treatment, and prevention amongst sport rock climbers: medial epicondylitis, brachialis tendonitis, biceps brachii tendonitis, ulnar collateral ligament sprain of the elbow, carpal tunnel syndrome, digital flexor tendon pulley sheath tears, interphalangeal joint effusions, fixed flexion deformities of the interphalangeal joints, and collateral ligament tears of the interphalangeal joints.
Conclusion: Many of the injuries are specific to the handhold types used by the rock climber. Accurate diagnosis and effective treatment of these unique injuries will be facilitated by a wider understanding of the biomechanical aspects of rock climbing and an awareness of the patterns and incidence of injuries in this sport.
Innis PC
Current Opinion in Pediatrics 7(1):83-7, 1995 Feb
Injury is our children's greatest health problem, and pediatricians will frequently see finger and hand injuries in the office and emergency room. Many of these will be fingertip crush injuries, which are quite common in toddlers and are often undertreated. Pediatric finger and wrist fractures and sprains generally do well but require proper diagnosis and treatment. Innocent-looking wounds from glass lacerations may disguise extensive damage to underlying nerves, arteries, and tendons. Advances in microsurgery allow replantation of distal amputations even in young children and infants, although often not without complications. Thermal injuries and animal bites require early and aggressive treatment. As with many pediatric hand injuries, these injuries should be preventable, and the adverse consequences can be minimized with appropriate diagnosis and management.
Huelke DF, Moore JL, Compton TW, Samuels J, Levine RS
Journal of Trauma 38(4):482-8, 1995 Apr
Objective: Details on airbag injuries to the upper extremity are relatively unknown to clinicians. The injuries presented here should provide a clear understanding of the mechanisms of forearm, hand, and wrist injuries that may be seen by emergency room physicians.
Materials and Methods: From our crash investigations of 325 airbag-equipped passenger cars, a subset of upper extremity injuries are presented that are related to airbag deployments.
Main Results: Minor hand, wrist, or forearm injuries--contusions, abrasions, and sprains--are not uncommonly reported. Infrequently, hand fractures have been sustained and, in isolated cases, fractures of the forearm bones or of the thumb, wrist, and fingers. The close proximity of the forearm to the airbag module door is related to most of the fractures identified. Steering wheel airbag deployments can fling the hand-forearm into the instrument panel, rearview mirror, or windshield, as indicated by contact scuffs, tissue debris, or the star burst (spider web) pattern of windshield breakage in front of the steering wheel.
Conclusion: Minor injuries of the upper extremity can occur when contacted by the deploying airbag either directly or by flinging the hand-forearm into interior car structures. Fractures of the forearm are rare and usually are due to direct impact by the forceful opening of the airbag module door.
Katarincic JA
Occupational Medicine 13(3):549-68, 1998 Jul-Sep
The hands are extremely vulnerable to injury because of their constant use. This chapter features analyses of the evaluation, treatment, rehabilitation, and complications of fractures of the distal radius, carpus, metacarpals, and phalanges.
Maupin BK
Occupational Medicine 13(3):533-47, 1998 Jul-Sep
Treatment of some complex disorders of the hand and wrist joints continues to challenge even the most experienced clinician. Dr. Maupin discusses both these injuries and the simpler ligament disorders that commonly result from everyday activities.
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