Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
S Afr Fam Pract (2004). 2022 Apr 19;64(1):e1-e4. doi: 10.4102/safp.v64i1.5479.
Acute hand injuries are routinely managed by family medicine and primary care physicians. An appropriate initial assessment and treatment, early referral to a hand surgeon when indicated, and timeous referral to a hand therapist are imperative. A patient case report is presented reporting on the initial and subsequent assessment, treatment and outcomes at 3, 6, 7 and 9 months for a patient who sustained an acute finger injury. Finger range of motion (ROM), sensation, pain, time of wound closure, hand function measured with the standardised disability of the shoulder, arm and hand (DASH) questionnaire were the outcomes used. Pain, crepitus, decreased sensation, decreased ROM right index finger proximal interphalangeal joint (PIPJ) and dense scarring was measured at 9 months. Missed injuries or lack of recognition of injury severity leads to delayed referral to specialist hand surgeons and therapists, which lengthens recovery time and leads to sub-optimal outcomes. This article aims to provide the primary care practitioner with the initial management of a patient who sustained a traumatic hand injury whilst using a power tool.
急性手部损伤通常由家庭医学和初级保健医生进行管理。适当的初步评估和治疗、在需要时及早转介给手部外科医生、以及及时转介给手部治疗师是至关重要的。本文报告了一位患者急性手指损伤的初始和后续评估、治疗和 3、6、7 和 9 个月时的结果。使用的结果包括手指活动度(ROM)、感觉、疼痛、伤口闭合时间、用标准化的肩部、手臂和手残疾(DASH)问卷测量的手部功能。9 个月时测量到疼痛、弹响、感觉减退、右侧食指近节指间关节(PIPJ)ROM 减少和致密瘢痕形成。错过损伤或未能识别损伤严重程度会导致延迟转介给手部外科医生和治疗师,从而延长康复时间并导致结果不理想。本文旨在为使用动力工具导致手部创伤的患者提供初级保健医生的初步管理方法。