Hand injuries in polytrauma patients.

Abstract

Hand and forearm injuries are relatively rare in polytrauma patients; their incidence is estimated on 2-5%. They are usually not life threatening, and, therefore are considered of secondary importance, replaced by serious injuries of other body parts. However, they should be treated immediately after stabilization of the general condition of the patients, as their delayed fitting may result in serious dysfunction of the hand. The aim of this study was determine the incidence, distribution and methods of treatment of hand and forearm injuries in the patients treated in Polytrauma Centre of the SPSK 1 in Szczecin, over the period of 4 years. Medical records of 16 patients, 11 men (65%) and 5 women (35%) at the mean age of 34 years (range 19-62) who were treated in Polytrauma Centre and sustained an additional injury to the hand and/or forearm were analysed. Results. The most common component of polytrauma with associated hand injury was major bone fractures (spine, pelvis and extremities) - 12 cases (70%), followed by chest - 11 (65%), maxillofacial - 9 (53%), brain - 8 (47%) and abdominal injuries - 5 (29%). The most common injury of the distal upper limb was fracture of the distal radius - in 9 patients (53%). Two patients sustained excessive crush-degloving injuries which were primary cause of their admission into Polytrauma Centre. Nine patients required surgery, predominantly fixation of the distal radius with plate. All patients survived. The importance of the correct fitting of hand injuries, promptly after stabilization of the general condition of polytraumatized patients was emphasized.