J Korean Orthop Assoc.  1972 Mar;7(1):83-92. 10.4055/jkoa.1972.7.1.83.

A Clinical Analysis of Wringer Injury of the Hand: A report of 25 cases

• Rah SK

• KMID: 2463850
• DOI: http://doi.org/10.4055/jkoa.1972.7.1.83

Abstract

Injury of the hand has been steadily increasing in this country in recent years, accordingly the proper surgical care for recently injured hand can not be overemphasized. The author has experienced 25 cases of wringer injuries of the hand in the years 1965 to 1971, and the results of the treatment is reported in this paper. 1. 12 cases out of 25 were in age group between 16 to 20 year. 23 cases were male and two cases were female. The incidence was remarkably higher in male. 2. Mode of the injury; All the cases were injured on the joh in factory. 17 cases were injured by a roller machine with or without gears. Four cases were injured by a belt, and three cases were injured by a pressor. 3. Extent of the injury was classified in 10 groups. Avulsion of the skin below the palmar crease were six cases, and below the wrist were in other groups. 4. Fracture and traumatic amputation in the hands were complicated in 16 cases out of 25. 5. 20 cases out of 25 were treated with primary skin repair followed by debridement of the wound. Among them three cases obtained primary healing, and 17 cases had to be treated by repeating surgeries. Five cases out of 25 were treated with delayed primary skin graft, and four cases obtained primary healing. Accordingly the delayed primary skin graft had much better result than primary skin repair in this series. 6. 19 cases out of 25, had surgical amputation in the hands, among them 16 cases had complicated with fracture and traumatic amputation. The incidence of surgical amputation was higher on the proximal phalanx in 33 fingers out of 59 surgically amputated fingers. 7. 23 cases out of 25 were treated by skin graft. The result of primary healing in primary skin graft was three out of 12, and that of secondary skin graft was five out of six, and that of third skin graft was seven out of 10, and that of fourth skin graft was five out of seven, and that of fifth skin graft was one case. Accordingly, the result of primary healing was considerably higher in the group of the secondary skin graft. 18 cases out of 23 of skin graft were split thickness graft, four were full thickness graft and one was full thickness combined with split thickness skin graft. 8. Seven cases of contracture developed in the webs and joints after the healing of the skin graft were treated by web plasty and arthrodesis. One case had had surgical amputation of four fingers at the metacarpophalangeal joints was treated by resection of the second and third metacarpus, which made the hand possibIe to pinch and grasp.

MeSH Terms

Amputation
Amputation, Traumatic
Arthrodesis
Contracture
Debridement
Female
Fingers
Hand Strength
Hand*
Humans
Incidence
Joints
Male
Metacarpophalangeal Joint
Metacarpus
Skin
Transplants
Wounds and Injuries
Wrist