A descriptive prospective study of 16 children with injuries inflicted by bicycle spokes and chain was undertaken to identify the demographic profiles of such injuries. Aspects of preventive measures are proposed.
Ring removal is indicated in a number of clinical circumstances to manage or prevent tourniquet effect of the digit. A ring made from hardened metal may defy commonly known methods of removal. We reported a case of unusual difficulty in removing a ring of hardened metal composition using a dental drill. We believed the unusual circumstances of this case is likely to be repeated in some other clinical practice and this instrument is an appropriate option to consider in such cases.
We have compared a simple four-strand flexor tendon repair, the single cross-stitch locked repair using a double-stranded suture (dsSCL) against two other four-strand repairs: the Pennington modified Kessler with double-stranded suture (dsPMK); and the cruciate cross-stitch locked repair with single-stranded suture (Modified Sandow). Thirty fresh frozen cadaveric flexor digitorum profundus tendons were transected and repaired with one of the core repair techniques using identical suture material and reinforced with identical peripheral sutures. Bulking at the repair site and tendon-suture junctions was measured. The tendons were subjected to linear load-to-failure testing. Results showed no significant difference in ultimate tensile strength between the Modified Sandow (36.8 N) and dsSCL (32.6 N) whereas the dsPMK was significantly weaker (26.8 N). There were no significant differences in 2 mm gap force, stiffness or bulk between the three repairs. We concluded that the simpler dsSCL repair is comparable to the modified Sandow repair in tensile strength, stiffness and bulking.
Chronic embedded-ring injury is a rare and uncommon presentation. This is also known as "chronic ring erosion" or "embedded ring syndrome" in the literature. Injury of this type has been associated with psychological impairment causing neglect of such injury. We herein describe a case of double embedded rings on the right ring finger in a 30-year-old healthy construction worker. A primary amputation at the metacarpophalangeal joint was performed in view of the chronicity of his condition and associated neurovascular damage. Early removal of ring is of paramount importance in any ring-associated injuries. However, fear of losing a digit has been the reason of delay in seeking medical treatment, which in turn ended up in dire consequences.
We are reporting four cases of serious washing machine related injury that presented within a period of 5 months. All patients were young children with the mean age of 9 year-old and three had their dominant hand injured. The washing machines involved were the automatic top loader type and all injuries occurred during the spinning phase. Serious automatic washing machine injury is not uncommon in Malaysia. We feel that there is a need to improve the safety features especially during the spinning phase. The operating instructions and safety precautions on the washing machine should be displayed in different languages that can be understood well. Parents should also aware of the potential risks of this seemingly benign household appliance.
A 19-year-old Malay male succumbed to a septicaemia caused by Chromobacterium violaceum 11 days after onset of illness. The organism is a common soil saprophyte and may be considered as contaminant on culture. It is essential to recognise its clinical significance in purulent processes so that appropriate therapy can be instituted. We report the first fatal case of Chromobacterium violaceum infection in the University Hospital, Kuala Lumpur.
Work-Related Hand Injuries (WRHIs) may result in disability and diminished productivity and cause economic impacts not only to the individual, worker’s families and industries, but to the local community as well.
Objectives: To determine the prevalence of severe Work-Related Hand Injuries (WRHIs) and factors associated at a tertiary hospital.
Methods: A pre-tested validated questionnaire was used to obtain data. All patients 18 years and above with WRHIs seen at a tertiary hospital between January 2010 and June 2010 were included in the study. Data was analysed using SPSS version 18.
Results: Out of the 297 industrial accidents, 74 (24.9%) were WRHIs. Among those with WRHIs, (47.3%) of them had severe hand injuries. The overall mean age of the respondents was 30.36 (± 9.54 SD) years. Majority (82.5%) of the injuries occurred between Mondays to Friday. Majority (70.1%) of hand injuries were caused by machine and 48.6% of the hand injuries occurred when the hand was caught in the operating part of the machine. Majority (62.1%) of the respondents had fingers’ injuries and 32.4% had open fracture. Bivariate analysis showed that there was significant association between severity of WRHIs and locations of injury, mechanisms of injury, sources of injury and sectors of industry (p < 0.05). Logistic regression analysis showed that WRHIs was significantly associated with source of injury and sector of industry. Respondents with hand injury resulted while operating on mechanical machine was 26 times more likely to report severe WRHIs than those with other sources of their hand injury like (sharp tool, heavy door, and wet floor). Respondents working in metal-machinery industries were eight times more likely to report severe WRHIs than those who working in other sectors of industry like (wood-furniture, constriction, food preparing, service and automotive).
Conclusions: WRHIs contributed to 24.9% of all industrial accidents seen at the emergency department and orthopaedic clinic and 47.3% of the respondents with WRHIs had severe hand injuries. Severity of WRHIs was significantly associated with sources of injury and sectors of industry.
Study site: emergency room, orthopaedic ward, general surgery ward and the orthopaedic outpatient clinic of a tertiary hospital