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1.
Medicine (Baltimore) ; 99(28): e21216, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664172

RESUMO

INTRODUCTION: The anterolateral thigh (ALT) flap is the most popularly used flap for major soft tissue reconstruction. Although it is widely used, acute compartment syndrome (ACS) in pediatric patients has rarely been reported in the literature. We herein reported a case of ACS in a 6-year-old girl after ALT flap harvest with direct closure of the donor site. PATIENT CONCERNS: A 6-year-old girl was admitted to the Second Hospital of Jilin University with crush injury on the palmar aspect of the right hand and wrist. DIAGNOSIS: Examination showed soft tissue defect of the hand and wrist, damage on the thenar muscles, lightly crushed flexor tendons, crushed median nerve, and ulnar artery thrombosis. INTERVENTIONS: The defect was closed with an ipsilateral ALT flap measuring 9 cm in length by 6 cm in width. OUTCOMES: After debridement was performed 3 times, the majority of the rectus femoris and lateral femoris were removed. Secondary closure by skin grafting was performed 2 weeks later. Three days after the procedure, necrotic tissues were noted on the edges of the wound. The diagnosis of ACS of the right was made. A second exploration was decided, and an extensive anterior compartment fasciotomy was performed. After 6 weeks of vacuum sealing drainage therapy, the defect was closed with a free latissimus dorsi musculocutaneous flap. At 4 months of follow-up, the right thigh wound had healed. At 6 months of follow-up, quadriceps muscle weakness remained. At 1 year of follow-up, the patient's mobility had been significantly improved, but diminished sensation remained on the lateral aspect of the thigh. CONCLUSION: ACS can occur after ALT flap harvesting in pediatric patients and should be recognized as early as possible to avoid devastating complications.


Assuntos
Síndromes Compartimentais/etiologia , Complicações Pós-Operatórias/etiologia , Transplante de Pele/efeitos adversos , Retalhos Cirúrgicos , Coxa da Perna/cirurgia , Doença Aguda , Criança , Lesões por Esmagamento/cirurgia , Feminino , Traumatismos da Mão/cirurgia , Humanos , Traumatismos do Punho/cirurgia
3.
Medicine (Baltimore) ; 99(23): e20504, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501996

RESUMO

RATIONALE: Acute compartment syndrome (ACS) is a feared complication following traumatic injuries. We describe the occurrence of silent ACS of the hand in a 2-year old patient with atypical symptoms. PATIENT CONCERNS: Our patient experienced massive swelling but minimal pain of the hand after a heavy bistro table with a stone tabletop had fallen on the right hand. DIAGNOSIS: After monitoring the development of ACS for 1 night, we noted increased firmness of the swelling and impaired perfusion of the skin covering the palm and dorsum of the hand. Notably, the patient held the hand in an intrinsic minus position but did not complain of pain after administration of only a single (weight-matched) dose of ibuprofen. Our suspicion of ACS was confirmed intraoperatively because of the elevated intramuscular pressure (up to 60 mm Hg) in several hand compartments. INTERVENTIONS: We performed surgical fasciotomy of all hand compartments, followed by temporary coverage of the wounds with Epigard synthetic skin substitute. The wounds were closed stepwise after 2 and 7 days, and occupational therapy was initiated after 3 weeks. OUTCOMES: At the 1-year follow-up, we noted unrestricted wrist and finger functions of the patient. The parents reported that there was no difference in the use of the 2 hands during daily activities. LESSONS: The possible development of ACS should be borne in mind even in the absence of marked pain. Although the 3 A's (i.e., anxiety, agitation, and increased analgesic requirements) in the diagnosis of ACS in children are well established, some patients may experience only minimal pain. This challenges the correct and timely diagnosis of ACS in children, particularly if they are very young.


Assuntos
Síndromes Compartimentais/etiologia , Lesões por Esmagamento/complicações , Pré-Escolar , Síndromes Compartimentais/cirurgia , Fasciotomia/métodos , Feminino , Mãos/cirurgia , Traumatismos da Mão/complicações , Traumatismos da Mão/cirurgia , Humanos , Pediatria/métodos , Suíça
4.
Postgrad Med J ; 96(1137): 379-383, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32522845

RESUMO

INTRODUCTION: Managing healthcare service during pandemics and outbreaks is a challenging process. The aim is to keep patient safety as the priority, besides, continuing to provide essential healthcare services. METHODS: Situational audit was performed for the services rendered before and during COVID-19 pandemic and the elevation of the disease alert status, and a retrospective analysis of the attendance and procedures performed in the service. RESULTS: We present a methodology for performing a situational audit and generating service modification for hand and reconstructive microsurgery unit in a pandemic. There was no significant difference between the number of patients seen at outpatient clinics. However, there was a reduction in the numbers of total surgeries performed, with a 40% drop in the number of elective surgeries performed. There was also a reduction of cases seen in the emergency department hand clinic. DISCUSSION: COVID-19 pandemic is currently affecting not only the health service but also, other vital services all over the world. The pandemic puts significant challenges to acute surgical services in a hospital system involved in the management of the pandemic. Surgeons need to take proactive and a systematic approach in managing the available resources while maintaining essential surgical services. This paper provides the tools and methodology for doctors to plan their services in a pandemic situation. CONCLUSIONS: It is possible to maintain essential surgical services in a pandemic situation through rapid situational audits and generating localised strategies while considering the constraints imposed during the pandemics while maintaining patient and staff safety.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/métodos , Traumatismos da Mão/cirurgia , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Reconstrutivos/métodos , Auditoria Clínica , Humanos , Microcirurgia , Segurança do Paciente , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Singapura/epidemiologia
6.
PLoS One ; 15(3): e0229982, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155201

RESUMO

BACKGROUND: Hand injuries (HI) are common and may limit participation in work. The objective of this study is to examine the effect of ethnicity and other prognostic variables on return-to-work (RTW) among male manual workers after acute HI. METHODS: A cohort of 178 subjects (90 Arabs, 88 Jews) aged 22 to 65 was studied. Trained bilingual occupational therapists evaluated and interviewed the subjects, using structured validated questionnaires for evaluating personal and environmental factors, body function and structure, and activity limitation and participation restrictions. Employment status 3 months post injury was assessed by a telephone interview. To establish a predictive model for RTW, ethnicity and certain variables of the four domains mentioned above were analyzed using logistic regression analysis. RESULTS: A significant difference in the rate of RTW between Jews and Arabs was found (45.5% for Jews, 28.9% for Arabs, p = 0.03) three months post HI. In the univariate regression analysis, ethnicity was associated with RTW (OR = 2.05; CI: 1.10-3.81) for Jews vs. Arabs. Using a multivariate analysis, only legal counseling, educational attainment, and the severity of disability were significantly associated with RTW. CONCLUSION: RTW three months post HI among manual workers is directly related to variables such as education and legal counseling and only indirectly related to ethnicity. Patients with a lower level of education and those who were engaged in legal counseling need special attention and close guidance in the process of RTW.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Traumatismos da Mão/etnologia , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Adulto Jovem
7.
Medicine (Baltimore) ; 99(11): e19513, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176099

RESUMO

A good mobile phone design may increase the productivity of users, as well as their comfort. To achieve mobile users' satisfaction, there is a need to come up with an ideal measurement that would not strain the human's body parts used to control the devices.To investigate the correlation between smartphone and hand anthropometry measurements and the development of hand discomfort and pain.89 Ahlia University students between the ages of 17- and 30-year-old participated in this study. Participants completed a demographic data sheet and had both of their hand dimensions and grip strength measured.A total number of 89 participants were recruited in this study with (57.3%) females and (42.7%) males. 38% have had hand pain recently while 61.8% did not experience any hand pain. There was weak negative correlation between the phone size (r = -0.04, P = .7), hand size (r = -0.08, P = .5), and the hand grip strength (r = -0.03, P = .7) all with the reporting of hand pain. For the phone screen size and the hand lengths (r = 0.22, P = .13) there was weak positive correlation.Mobile phone manufacturers should take into account the users' comfort when designing their phones as this could lead to hand pain and other musculoskeletal problems. Furthermore, hand pain is multifactorial so hand size; phone size and grip strength may be taken into account.


Assuntos
Antropometria , Traumatismos da Mão/etiologia , Força da Mão , Dor/etiologia , Smartphone , Adolescente , Adulto , Estudos Transversais , Feminino , Traumatismos da Mão/fisiopatologia , Humanos , Masculino , Dor/fisiopatologia , Medição da Dor , Valores de Referência , Adulto Jovem
8.
AJR Am J Roentgenol ; 214(4): 871, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32045309

RESUMO

OBJECTIVE. The purpose of this article is to show the sonographic anatomy of the extremities relevant to various ligamentous, tendinous, and articular injuries occurring in the hand, wrist, and ankle. A brief discussion and depiction of the specific elements relevant to the pathophysiologic mechanism of these entities is followed by demonstrations of the dynamic ultrasound techniques that can be used to diagnose these injuries. The schematics and video clips illustrate the normal and pathologic features of these injuries. The first two videos discuss soft-tissue injuries to the hand and wrist, and the third addresses ankle injuries. CONCLUSION. After clinical assessment, dynamic ultrasound examination is a useful tool for diagnosing and assessing the degree of severity of several soft-tissue injuries to the extremities, some of which can be detected only during active movement. Familiarity with these specific dynamic techniques will enhance the value of the ultrasound examination.


Assuntos
Traumatismos do Tornozelo/diagnóstico por imagem , Traumatismos da Mão/diagnóstico por imagem , Lesões dos Tecidos Moles/diagnóstico por imagem , Ultrassonografia/métodos , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Tornozelo/fisiopatologia , Traumatismos da Mão/fisiopatologia , Humanos , Lesões dos Tecidos Moles/fisiopatologia , Traumatismos do Punho/fisiopatologia
11.
J Athl Train ; 55(2): 188-194, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31913657

RESUMO

CONTEXT: Most studies of injury trends associated with softball focus on injuries requiring at least 24 hours of missed participation time (time-loss [TL] injuries), with little focus on those that do not (non-time-loss [NTL] injuries). A better understanding of injury trends associated with softball will improve athlete care. OBJECTIVE: To describe NTL and TL injuries experienced by secondary school girls' softball players. DESIGN: Descriptive epidemiology study. SETTING: Secondary school athletic training clinics. PATIENTS OR OTHER PARTICIPANTS: Secondary school girls' softball players. MAIN OUTCOME MEASURE(S): Aggregate data were collected from schools participating in the National Athletic Treatment, Injury, and Outcomes Network surveillance program during the 2011-2012 through 2013-2014 academic years. Frequencies and rates of injuries (NTL and TL) according to time of season, event type, body part injured, and diagnosis were analyzed. RESULTS: In total, 1059 injuries were reported during 140 073 athlete-exposures (AEs): overall injury rate = 7.56/1000 AEs. Of these injuries, 885 (83.6%) were NTL (NTL rate = 6.32/1000 AEs) and 174 (16.4%) were TL (TL rate = 1.24/1000 AEs). Of the NTL and TL injuries, the largest numbers occurred during the regular season (NTL: n = 443 [50.1%]; TL: n = 131 [75.3%]). Injuries sustained during practices accounted for the majority of NTL and TL injuries (NTL: n = 631 [71.3%]; TL: n = 104 [59.8%]). The NTL injuries occurred most often at the shoulder (n = 134 [15.1%]) and hand/fingers (n = 109 [12.3%]) and were diagnosed as contusions (n = 316 [35.7%]), strains (n = 157 [17.7%]), and abrasions (n = 151 [17.1%]). The largest numbers of TL injuries were to the head/face (n = 71 [40.8%]) and diagnosed as concussions (n = 50 [28.7%]) and strains (n = 28 [16.1%]). CONCLUSIONS: Secondary school softball players sustained a larger proportion of NTL injuries than TL injuries. Although NTL injuries may be less severe, they are numerous. Efforts are needed to ensure that injury-prevention programs are incorporated into the care of softball athletes to promote health and reduce injury occurrence.


Assuntos
Traumatismos em Atletas/epidemiologia , Beisebol/lesões , Adolescente , Concussão Encefálica/epidemiologia , Contusões/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Faciais/epidemiologia , Feminino , Traumatismos dos Dedos/epidemiologia , Traumatismos da Mão/epidemiologia , Humanos , Incidência , Volta ao Esporte , Instituições Acadêmicas , Estações do Ano , Lesões do Ombro/epidemiologia , Entorses e Distensões/epidemiologia , Estados Unidos
12.
Ulus Travma Acil Cerrahi Derg ; 26(1): 115-122, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31942748

RESUMO

BACKGROUND: This single-center, retrospective study aims to analyze the sociodemographic, injury characteristics, and the total number of lost working days of patients undergoing hand flexor tendon repair and to identify factors predicting reoperation. METHODS: Hand flexor tendon repairs conducted using a four-strand modified Kessler core suture with early rehabilitation from January 2013 to December 2016 were included in this study. The variables evaluated in this study were patient sociodemographic and injury characteristics, number of lost working days, and reoperations because of rupture and/or adhesion formation. Injury severity was determined using Modified Hand Injury Severity Scoring (MHISS). Binary logistic regression analysis was conducted to identify the predictors of reoperation. RESULTS: A total of 194 patients were included in this study, who had experienced 329 tendon injuries. Participants were young (mean age, 31.8), mostly male (79.4%), and mostly blue-collar workers (50.0%). Most patients had a zone 2 injury affecting a single digit of the dominant hand. The mean MHISS value was 46.6, and the mean time to return to work was 114.0 days. A total of 37 (19.1%) patients required reoperation because of rupture and/or adhesion formation. Smoking, zone 2 injury, and high MHISS value were negative predictors of reoperation. CONCLUSION: To minimize the need for reoperation, surgeons and rehabilitation teams should take special care of patients with zone 2 injuries, high MHISS values, and smoking history.


Assuntos
Traumatismos da Mão , Reoperação/estatística & dados numéricos , Traumatismos dos Tendões , Adulto , Feminino , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/fisiopatologia , Traumatismos da Mão/cirurgia , Humanos , Escala de Gravidade do Ferimento , Masculino , Estudos Retrospectivos , Traumatismos dos Tendões/epidemiologia , Traumatismos dos Tendões/fisiopatologia , Traumatismos dos Tendões/cirurgia
13.
Unfallchirurg ; 123(2): 97-103, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31915879

RESUMO

Injuries to the flexor tendons in children are less common than in adults. The clinical examination and diagnostics require extensive experience. Leaving flexor tendons untreated will result in growth disorders of the affected finger. Therefore, the indications for operative exploration of any type of open injury in a child's hand should be liberally applied. As for adults the primary treatment of flexor tendon injuries as an emergency is rarely indicated. In the recent literature various tendon suture techniques and rehabilitation protocols have been differently assessed. According to the Ulm algorithm flexor tendon injuries in children are treated by a 2-strand core stitch technique followed by a continuous circular suture. Children under 6 years of age are postoperatively immobilized for 3 weeks with a fist bandage. Children older than 6 years are treated like adults with a dynamic aftercare as described by Kleinert for 5 weeks. The results are comparable with those of other aftercare protocols.


Assuntos
Traumatismos dos Dedos , Traumatismos da Mão , Traumatismos dos Tendões , Criança , Traumatismos dos Dedos/cirurgia , Traumatismos da Mão/cirurgia , Humanos , Técnicas de Sutura , Traumatismos dos Tendões/cirurgia , Tendões
14.
Plast Reconstr Surg ; 145(2): 471-481, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985644

RESUMO

BACKGROUND: Hand surgeons can alleviate the burden associated with various congenital anomalies, burn sequelae, and trauma that debilitate individuals in low- and middle-income countries. Because few surgeons in these areas have the necessary resources to perform complex hand surgery, surgical trips provide essential surgical care. The authors aimed to determine the economic benefit of hand surgical trips to low- and middle-income countries to comprehensively determine the economic implications of hand surgery trips in low-resource settings. METHODS: The authors collected data from two major global hand surgery organizations to analyze the economic benefit of hand surgery trips in low- and middle-income countries. The authors used both the human capital approach and the value of a statistical life-year approach to conduct this cost-benefit analysis. To demonstrate the economic gain, the authors subtracted the budgeted cost of each trip from the economic benefit. RESULTS: The authors analyzed a total of 15 trips to low- and middle-income countries. The costs of the trips ranged from $3453 to $87,434 (average, $24,869). The total cost for all the surgical trips was $373,040. The authors calculated a net economic benefit of $3,576,845 using the human capital approach and $8,650,745 using the value of a statistical life-year approach. CONCLUSIONS: The authors found a substantial return on investment using both the human capital approach and the value of a statistical life-year approach. In addition, the authors found that trips emphasizing education had a net economic benefit. Cost-benefit analyses have substantial financial implications and will aid policy makers in developing cost-reduction strategies to promote surgery in low- and middle-income countries.


Assuntos
Países em Desenvolvimento/economia , Deformidades Congênitas da Mão/economia , Traumatismos da Mão/economia , Mãos/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Análise Custo-Benefício , Assistência à Saúde/economia , Feminino , Deformidades Congênitas da Mão/cirurgia , Traumatismos da Mão/cirurgia , Humanos , Masculino , Turismo Médico/economia , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Gravidez , Anos de Vida Ajustados por Qualidade de Vida , Estudos Retrospectivos , Viagem/economia , Viagem/estatística & dados numéricos , Adulto Jovem
15.
Unfallchirurg ; 123(2): 114-125, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31822942

RESUMO

The secondary reconstruction of flexor tendons is in most cases very demanding and tedious. The indications, selection of the correct surgical procedure, operative technique and further treatment have to be individually adjusted and are mostly very difficult. Due to the previous operations unpleasant surprises may occur intraoperatively, which must be recognized and treated by the surgeon. Nevertheless, a significant improvement of the function of the whole hand can be achieved for most patients, e.g. by a two-stage flexor tendon transplantation or other techniques described in this article.


Assuntos
Traumatismos dos Dedos , Traumatismos da Mão , Procedimentos Ortopédicos , Traumatismos dos Tendões , Traumatismos dos Dedos/cirurgia , Mãos , Traumatismos da Mão/cirurgia , Humanos , Traumatismos dos Tendões/cirurgia
16.
Int J Sports Med ; 41(1): 54-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31747701

RESUMO

This study aimed to investigate exposure adjusted injury incidence rates and profiles associated with training and competition in an elite taekwondo athlete population. 82 athletes were investigated for injuries over a period of 5 years. Individual fight time exposure for training and competition was recorded. The type and location of the injuries were classified and exposure-adjusted injury incidence rates (IIR) were calculated per 1000 h for training and competition. 66 athletes with a mean age of 19.3±4.2 years and 172 injuries were included in the final data assessment. The exposure adjusted IIR was significantly higher during competition (p<0.001) with a rate ratio of 6.33 (95% CI 4.58-8.69). Ankle and foot region as well as hand and wrist were most affected with significant higher IIR in competition (p<0.001). Joint injuries, fractures, and bruising occurred the most. Fractures occurred mainly to the hand and wrist region. Future investigations should focus on exposure adjusted injury data including analyses of the detailed mechanism leading to especially severe injuries to improve specific injury prevention in competition and promote evolution of protective gear.


Assuntos
Traumatismos em Atletas/epidemiologia , Comportamento Competitivo/fisiologia , Artes Marciais/lesões , Condicionamento Físico Humano/efeitos adversos , Adolescente , Adulto , Traumatismos do Tornozelo/epidemiologia , Feminino , Traumatismos do Pé/epidemiologia , Traumatismos da Mão/epidemiologia , Humanos , Incidência , Masculino , Estudos Prospectivos , Traumatismos do Punho/epidemiologia , Adulto Jovem
17.
Clin Anat ; 33(1): 12-21, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30989719

RESUMO

Crucifixion was a widely used form of execution for capital crimes in antiquity. Civilizations and empires perfected the technique, leading to centuries of discussions, controversies, and questions, many of which concerned the death of Jesus Christ. To this day, much remains to be discovered in both religious and scientific realms. However, the aim of this study is to discuss such facts as are known from the medical perspectives of clinical anatomists. Nails/spikes were driven through the hands/wrists and feet of five adult cadavers, and the cadavers were then dissected to observe the anatomical structures that had been injured or placed at risk for injury. While many historical and archeological facts remain to be discovered, we hope that this cadaveric study will enhance our modern understanding of ancient practices from a medical and anatomical perspective. Clin. Anat. 32:12-21, 2019. © 2019 Wiley Periodicals, Inc.


Assuntos
Traumatismos do Pé/patologia , Pé/anatomia & histologia , Traumatismos da Mão/patologia , Mãos/anatomia & histologia , Ferimentos Penetrantes , Cadáver , Humanos , Masculino
18.
Plast Reconstr Surg ; 145(1): 172e-183e, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31881627

RESUMO

LEARNING OBJECTIVES: After studying this article, the participant should: 1. Be familiar with local, regional, and free flaps for reconstruction of the hand. 2. Be able to identify potential sources of tissue for vascularized coverage using an algorithmic approach to provide stable and functional reconstruction of the hand. 3. Recognize the controversies and complications unique to flap reconstruction of the hand. SUMMARY: The goal of this continuing medical education module is to provide the practicing reconstructive surgeon with a framework in which to think about reconstruction of the hand. The hand has unique functional and aesthetic characteristics that must be considered when choosing the optimal methods for reconstruction. There are a number of reliable local and regional flaps that can be used to treat the hand requiring soft-tissue coverage and/or vascularized bone graft. The "reconstructive ladder," originally described by Mathes and Nahai, is based on the principle of using the simplest approach that adequately restores form and ideally optimizes function. In cases where the simplest techniques prove to be inadequate, local and regional flaps and, ultimately, microsurgical tissue transfer should be considered.


Assuntos
Traumatismos da Mão/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos/transplante , Humanos , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Retalhos Cirúrgicos/efeitos adversos , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento
19.
Emerg Med Clin North Am ; 38(1): 61-79, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757255

RESUMO

Injury patterns of the hand and wrist can be complex and challenging for the emergency physician to diagnose and treat. The ability of the hand to perform delicate maneuvers requires a very intricate interplay of bones, ligaments, and tendons. Unfortunately, due to the omnipresence of the hand, the hand and wrist are commonly injured. These injuries can be debilitating if not treated correctly and can be both time-consuming and fraught with medicolegal risk. This article provides the necessary knowledge to diagnose and treat common hand and wrist injuries encountered in the emergency department.


Assuntos
Gerenciamento Clínico , Emergências , Fraturas Ósseas , Traumatismos da Mão , Procedimentos Ortopédicos/métodos , Radiografia , Traumatismos do Punho , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/terapia , Saúde Global , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/terapia , Humanos , Incidência , Traumatismos do Punho/diagnóstico , Traumatismos do Punho/epidemiologia , Traumatismos do Punho/terapia
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