Hand injury without any deficit: Is systematic surgical exploration justified?
| Autor: | Emmanuel Masmejean, D. Zbili, T. Bihel, Jean David Werthel, Johanna Sekri, Jérôme Pierrart, Thibault Lafosse, Lior Amsallem, Damien Delgrande |
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| Přispěvatelé: | Université Paris Descartes - Paris 5 (UPD5) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent [SDV]Life Sciences [q-bio] Population Physical examination 03 medical and health sciences Young Adult 0302 clinical medicine Anesthesia Conduction Peripheral Nerve Injuries Tendon Injuries medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Prospective Studies Surgical treatment education Child Physical Examination Aged 030222 orthopedics education.field_of_study integumentary system medicine.diagnostic_test Hand injury Missed Diagnosis business.industry Rehabilitation Hand Injuries Sequela Evidence-based medicine Middle Aged Vascular System Injuries medicine.disease 3. Good health Surgery Regional anesthesia Female business Emergency Service Hospital Joint Capsule |
| Zdroj: | Hand Surgery and Rehabilitation Hand Surgery and Rehabilitation, Elsevier, 2019, 38, pp.20-23. ⟨10.1016/j.hansur.2018.08.002⟩ |
| ISSN: | 2468-1229 2468-1210 |
| DOI: | 10.1016/j.hansur.2018.08.002⟩ |
| Popis: | Out of 100,000 inhabitants, 700 to 4000 suffer a hand wound each year. Numerous hand wounds that may not have a clinically evaluated deficit, actually have damage to a major structure after surgical exploration in the operating room (OR). The aim of our study was to evaluate the incidence of major structure damage within a population of patients presenting a hand wound with no deficit on the clinical examination. Every patient older than 12 years, consulting for a wound deeper than the dermis with no clinical signs of major structure damage underwent surgical treatment and exploration of the wound under regional anesthesia in the OR. After each surgery, the surgeon filled out an anonymous study form describing the wound characteristics and the potential findings of major structure damage. Of the 145 wounds with normal clinical examination, we found that 58.6% had a major structure damaged. Given that damage to any major structure in the hand can lead to functional sequela, and the fact that a well-conducted clinical examination by a qualified hand surgeon is not sufficient to eliminate major structure damage, we recommend systematic surgical exploration of hand wounds, even when no clinical deficit is evident. LEVEL OF EVIDENCE III.: Type of sudy: diagnostic study. |
| Databáze: | OpenAIRE |
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