TITLE

Diagnostic accuracy of preoperative clinical examination in upper limb injuries

AUTHOR(S)
Dehghani, Mohammad; Shemshaki, Hamidreza; Eshaghi, Mohammad Amin; Teimouri, Mehdi
PUB. DATE
October 2011
SOURCE
Journal of Emergencies, Trauma & Shock;Oct2011, Vol. 4 Issue 4, p461
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Injuries in hands and forearms may cause significant discomfort and disability. Aim: To evaluate the accuracy of preoperative clinical examination in depicting lesions caused by penetrating wounds of hands or forearms. Setting and Design: This prospective study was conducted from August 2006 to September 2009 at Kashani University Hospital, Isfahan University of Medical Sciences, Iran. Materials and Methods: Two hundred and fifty patients with clean penetrating injury to the hand/forearm were enrolled in this study. After patient's data registration, a careful clinical examination and routine exploration without expansion of wound were done by an orthopedic resident. Each tendon was tested at each joint level. Nerves were evaluated with a two-point discrimination test, and arteries were tested with palpable pulses. Surgical exploration was done by a single hand surgeon in operation room. Accuracy of clinical examination was compared to surgical examination. Results: During the study period, 180 (72%) males and 70 (28%) females with mean age of 28±4 years participated. The preoperative examination showed a predominance of the volar zone IV injuries followed by volar zone II, III, thumb zone II, volar zone V and thumb zone III. Despite the enough accuracy of preoperative examinations in dorsal side injuries of hands and forearms (error rate = 8.3%), the preoperative examinations significantly underestimated the amount of damage to soft tissues on the volar side of hands and forearms (error rate = 14%). Conclusions: The precise surgical evaluations should be considered in patients with penetrating injury to the hand or forearm, especially in those with volar side injuries.
ACCESSION #
69615538

 

Related Articles

  • Erratum.  // International Journal of Dentistry;2014, p1 

    No abstract available.

  • Non-surgical treatment of pain associated with posterior tibial tendon dysfunction: study protocol for a randomised clinical trial. Blasimann, Angela; Eichelberger, Patric; Brülhart, Yvonne; El-Masri, Isam; Flückiger, Gerhard; Frauchiger, Lars; Huber, Martin; Weber, Martin; Krause, Fabian G.; Baur, Heiner // Journal of Foot & Ankle Research;Aug2015, Vol. 8 Issue 1, p1 

    Background: Symptoms associated with pes planovalgus or flatfeet occur frequently, even though some people with a flatfoot deformity remain asymptomatic. Pes planovalgus is proposed to be associated with foot/ankle pain and poor function. Concurrently, the multifactorial weakness of the tibialis...

  • Does Cryotherapy Improve Outcomes With Soft Tissue Injury? Hubbard, Tricia J.; Denegar, Craig R. // Journal of Athletic Training (National Athletic Trainers' Associ;Jul-Sep2004, Vol. 39 Issue 3, p278 

    Reference: Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sport Med. 2004; 32:251-261. Clinical Question: What is the clinical evidence base for cryotherapy use? Data Sources: Studies...

  • Surgical management of unstable elbow dislocation without intra-articular fracture. Micic, Ivan; Kim, Shin-Yoon; Park, Il-Hyung; Kim, Poong-Taek; Jeon, In-Ho // International Orthopaedics;Aug2009, Vol. 33 Issue 4, p1141 

    The purpose of this study was to describe soft tissue injury patterns and report the clinical results of primary ligament repair with use of protected early mobilisation in unstable elbow dislocations with pure capsulo-ligamentous injuries. Twenty-four patients who presented with traumatic...

  • Chondroma of the Subcutaneous Bursa of the Achilles Tendon. Oliva, Francesco; Venanzi, Riccardo; Fratoni, Stefano; Maffulli, Nicola // Bulletin of the NYU Hospital for Joint Diseases;2005, Vol. 63 Issue 1/2, p24 

    A 46-year-old female presented a six-month history of posterior heel pain. Clinical and radiographical examination revealed a nodular calcified mass into the subcutaneous tissue of the Achilles tendon bursa. Following excision, histopathology showed an extraskeletal soft-tissue chondroma. Follow...

  • 'The BloodStopper' - experiences with a novel portable hand-held orthopaedic limb tourniquet. Millar, T. M. S.; McConnachie, C. C. P. // Tropical Doctor;Oct2007, Vol. 37 Issue 4, p202 

    Tourniquets are widely employed in orthopaedic practice to maintain a bloodless operative field during extremity surgery. In areas of the world where reliable pressurized air systems for tourniquet inflation are not available, and as an alternative to the traditional Esmarch bandage, we report...

  • Damage control orthopaedics. Philipson, Mark R.; Parker, Paul J. // Trauma;Oct2007, Vol. 9 Issue 4, p245 

    Damage control orthopaedics (DCO) describes a philosophy for the management of the patient with multiple bony injuries. The fundamental principles are that fractures and traumatic soft tissue injuries (the 'wound organ') should be stabilised promptly with the minimum physiological insult to the...

  • Soft tissue coverage of war extremity injuries: the use of pedicle flap transfers in a combat support hospital. Mathieu, Laurent; Gaillard, Christophe; Pellet, Nicolas; Bertani, Antoine; Rigal, Sylvain; Rongiéras, Frédéric // International Orthopaedics;Oct2014, Vol. 38 Issue 10, p2175 

    Purpose: Definitive management of extremity injuries including soft tissue coverage is seldom achieved in battlefield medical treatment facilities due to limited resources and operational constraints. The purpose of this study was to analyse the French Army Medical Service experience performing...

  • A Novel Modeling Framework for Multilayered Soft Tissue Deformation in Virtual Orthopedic Surgery. Jing Qin; Wai-Man Pang; Yim-Pan Chui; Tien-Tsin Wong; Pheng-Ann Heng // Journal of Medical Systems;Jun2010, Vol. 34 Issue 3, p261 

    Realistic modeling of soft tissue deformation is crucial to virtual orthopedic surgery, especially orthopedic trauma surgery which involves layered heterogeneous soft tissues. In this paper, a novel modeling framework for multilayered soft tissue deformation is proposed in order to facilitate...

Share

Read the Article

Courtesy of NEW JERSEY STATE LIBRARY

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics