77th ASSH Annual Meeting - Back to Basics: Practice and Education-IC29: The Urban Mangled Hand: Tips for Approaching Devastating Hand Injuries from Atypical Mechanisms (AM22)

IC29: The Urban Mangled Hand: Tips for Approaching Devastating Hand Injuries from Atypical Mechanisms (AM22)

Video Transcription

Video Summary

The topic of the discussion was the management of hand injuries caused by urban mangled hands, specifically electrocution, ballistic injuries, and fireworks injuries. Mechanism of injury is important in determining the zone of injury and tissue structures affected. Debridement is critical, but the amount depends on the mechanism. The zone of injury can be dynamic and change over time, either decreasing or increasing. Electrocution injuries are severe and unique, requiring extensive examination and careful assessment of multiple organ systems. Ballistic injuries, especially high-energy ones, are common in urban areas and can cause significant damage. Fireworks injuries can be devastating, and the choice of treatment depends on the severity of the injury. Surgery for electrical burns can be divided into three phases: acute amputation, fasciotomy and nerve decompression, wound cover, and secondary reconstruction. In ballistic injuries, fracture management is non-operative, usually involving external fixation for stability. Soft tissue management is crucial, and coverage can be delayed. In fireworks injuries, blast injuries are the primary concern, and debridement and stabilization are the main treatment approaches. Observation is important for sensory and motor nerve injuries, and exploration may be required in some cases. In conclusion, the management of urban mangled hand injuries requires a comprehensive approach that takes into consideration the mechanism of injury, the specific injury patterns, and the unique challenges of each case.

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Session Tracks Fracture

Session Tracks Microsurgery

Session Tracks Nerve

Session Tracks Skin Soft Tissue

Speaker Hari Venkatramani, MD

Speaker Jacques Henri Hacquebord, MD

Speaker Jason A. Strelzow, MD, FRCSC

Speaker Patrick L. Reavey, MD

Keywords

hand injuries

urban mangled hands

electrocution

ballistic injuries

fireworks injuries

debridement

zone of injury

fracture management

soft tissue management

nerve injuries