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Introduction: This study evaluated hand and forearm injuries caused by angle grinders and identify the risk factors. Methods: Between 2020 and 2022, 79 patients with hand and forearm injuries due to angle grinder were retrospectively evaluated. Data were obtained from the hospital database and telephone interviews with patients. Age, gender, education level, employment status and work experience, smoking, and alcohol use were recorded. The injury location and structures were evaluated. The time of injury and use of protective gloves were recorded. The Modified Hand Injury Severity Score (MHISS) was used to determine the severity of the injury. The return to work times of actively working patients were recorded. Results: Seventy-nine patients with angle grinder injuries were included in the study. All patients were male. Dominant side injury was in 17 (21.5%) patients. The most frequently injured area was the dorsal hand, and the most frequently injured structure was the extensor tendon. The mean MHISS was 49.15 (4-280) and 39 (49.4%) patients had minor injuries. The mean return to work was 7.13 (2- 32) weeks. No correlation was found between age, work experience, and MHISS (p=0.167 p=0.389). There was a correlation between the use of protective gloves and MHISS (p=0.002). Conclusion: Injuries to the hand and forearm caused by angle grinder usage can result in serious work-related disabilities. These injuries can be reduced by increasing safety precautions and training. [ABSTRACT FROM AUTHOR]

Flexor tendon injuries of the hand have devastating consequences when primary tendon repair fails or left untreated in the first place. Flexor tendon reconstruction is a substantial treatment option to obtain functional digit. In this study, we aimed to compare the functional outcomes and technical feasibility of fingertip-to-palm and fingertip-to-forearm tendon reconstruction methods. Thirty-five patients were divided into two groups according to the proximal attachment site of the free tendon grafts. Group I consisted of 18 patients whose tendon grafts were placed from fingertip-to-palm (zone III). Group II consisted of 17 patients whose tendon grafts were placed from fingertip-to-forearm (zone V). The mean of 39.6 months (range, 6–52 months) of follow-up with complete clinical data were obtained for all the cases. The mean length of the tendon grafts used in group I and group II was 9.7 ± 1.4 cm and 15.9 ± 1.2 cm, respectively. Significantly shorter tendon grafts were needed in group I (p < 0.001). Both mean DASH score and mean Michigan score were significantly improved postoperatively in both groups (p = 0.0001, p = 0.0001), but there was no significant difference between two groups based on postoperative DASH score (p = 0.112) and Michigan score (p = 0.151). No statistically significant difference was observed between two groups in terms of Strickland's scores (p = 0.868). This study demonstrates that comparable results can be obtained with fingertip-to-palm and fingertip-to-forearm staged tendon reconstructions. Fingertip-to-palm tendon reconstruction seems to be more advantageous when multiple flexor tendon injuries aimed to be reconstructed, in which requirement of tendon graft can be fulfilled with less donor site morbidity. Abbreviations: DASH: disabilities of the arm, shoulder and hand [ABSTRACT FROM AUTHOR]

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Purpose: This study aimed to assess the diagnostic accuracy of smartphone photographs, taken at the emergency department (ED) and shared with hand surgeons, in identifying critical circulatory issues and neurovascular bundle injury, as well as tendon and bone injuries., Methods: The photographs of hand injuries of 50 patients who were referred to our ED between January 2020 and January 2022 were used to design a questionnaire. This questionnaire, including closed-ended questions about the injured structures, was shared with a group of hand surgeons via a WhatsApp group in Turkey. The experience levels of the surgeons were categorized as 0-5 years, 5-10 years, and above 10 years. Diagnostic accuracy was assessed by comparing the results with surgery notes as the reference standard., Results: A total of 94 hand surgeons participated in the study. The accuracy of predicting critical circulatory issues in the hand/fingers from the smartphone photographs was 81.9%, with a sensitivity of 48.0% and a specificity of 91.4%. For neurovascular bundle injuries, the accuracy was 63.0%, with a sensitivity of 63.9% and a specificity of 61.5%. The accuracy of predicting tendon injuries was 64.9%, with a sensitivity of 81.1% and a specificity of 42.5%. The accuracy of predicting fracture was 74.7%, with a sensitivity of 70.9% and a specificity of 79.9%., Conclusions: Identifying critical circulatory issues solely based on the shared photograph is inadequate. Similarly, evaluation based only on the photograph was insufficient for the detection of neurovascular bundle injuries, tendon ruptures, and fractures., Clinical Relevance: Digital images acquired in an ED setting and subsequent review of these images by hand surgeons may not be an adequately reliable strategy for determining the necessity of patient transfer., Competing Interests: Conflicts of Interest No benefits in any form have been received or will be received related directly to this article., (Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Objectives: In this study, we aimed to compare functional outcomes and complication rates of tripod technique and locked plate fixation used in Mason type 3 radial head fractures., Patients and Methods: Between January 2012 and December 2019, a total of 27 patients (16 males, 11 females; median age: 43.2 years; range, 20 to 68 years) with Mason type 3 radial head fractures were retrospectively analyzed. The patients were divided into two groups according to fixation method used. Group 1 consisted of 12 patients who were treated with tripod technique, and Group 2 consisted of 15 patients who were treated with locked plate fixation. Operation time, follow-up period, length of hospital stay, union time, Disabilities of Arm, Shoulder and Hand (DASH) scores, range of motions and complications were recorded., Results: The median time to bone union was 46.7 days in Group 1, which was significantly shorter than Group 2 (p<0.001). The median forearm pronation-supination arc was 123.75° (range, 30° to 180°) in Group 1 and was 94° (range, 45° to 180°) in Group 2. There was no significant difference in the forearm rotation between the groups. The median elbow flexion-extension arc was 99.17° (range, 65° to 130°) in Group 1 and was 80.33° (range, 30° to 130°) in Group 2. No statistically significant difference was found in the flexion-extension and pronation-supination arc degrees. There was no significant difference in the postoperative DASH scores between the groups (p=0.464)., Conclusion: Our study results demonstrate that comparable results can be achieved in both techniques regarding functional outcome and range of motion. With a shorter union time and less complication rates, the tripod technique should be considered as the primary treatment method for the comminuted radial head fractures without a metaphyseal defect.

Objectives: This study aims to compare the usefulness of two systems in classifying thumb duplication cases and give some examples of the cases we believe that are unclassifiable., Patients and Methods: Between January 2011 and January 2018, a total of 50 patients (29 males, 21 females; median age: 46.4±68.3 months; range, 1 to 318 months) with thumb duplications as assessed according to the Wassel and Rotterdam classification systems were included., Results: Duplication was present in the right hand in 28, in the left hand in 21, and in both hands in one patient. According to the Wassel classification system, 45 patients could be allocated in any of the types; however, five patients could not be classified. According to the Rotterdam classification, 47 cases fell into one of the classifications; however, three cases could not be classified., Conclusion: Despite efforts to find the best classification system for thumb duplications, the proposed systems may not fully cover the presented radial polydactyly cases, and additions to the system are required.