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E-poster presentation

DIAGNOSTIC IN HAND INJURY BEFORE OPERATION, DOES IT MATTER?


Angga Putra Kusuma 1, Lynda Hariani2
Department Of Plastic Reconstructive and Aesthetic Surgery
Airlangga University School Of Medicine, Dr. Soetomo Teaching Hospital Surabaya

ABSTRACT

Background
Hand injury is a common case. The causes can be Electric, Crush, Amputation,
Caught In, Struck By, Hot/ Cold Surfaces, Laceration, and Chemical Exposure. The
absence of hand should affect functional, and aesthetic. In USA more than
1.000.000 hand trauma occurred every year, about 20% of the disabling hand
trauma is an occupational injury. This case report will show the importance of ATLS
Protocol for the management of hand trauma.
Patients & Methods
Male, 37 years old, the left hand got stuck by peanut grinder machine at the market
when cleaning the grinder machine with a bare hand. The patient was taken to the
hospital 2 hours after the accident with the part of the machine still on his left hand
and a small rubber tourniquet applied at the brachii.
From the primary survey we assess as pre-shock. Initial treatment at emergency
department as follows: Oxygenation, Intravenous access, and bleeding control
After the patient was stable, the patient taken to operating theater for anesthesia and
pull out the grinder machine. The diagnostic was performed by using C-Arm X-ray
Systems. We assessed as crush injury regio manus sinistra et causa grinder
machine. We underwent amputation shaft metacarpal digiti II, III, IV and V manus
sinistra.
Results
The patient successfully underwent debridement and amputation of the shaft
metacarpal digiti II, III, IV and V manus sinistra. After 2 days, the patient admitted to
out of the hospital.
Conclusions
We have to ensure the patient was stable before underwent surgery, because not all
hand injury has to be done radiology diagnostic before taken to operating theater.
Keyword: Hand trauma, ATLS Protocol, diagnostic.