背景:这项研究的目的是评估过去三十年中以及通过COVID-19大流行引起的手部创伤的任何变化。我们假设改进了消费者安全法规,获得护理的机会发生变化,以及全球大流行的影响,在其他变量中,在20世纪80年代之间显著影响了手部受伤的机制和治疗,2010年代(COVID-19之前),和2020年代(后COVID-19)。
方法:在密西西比州唯一的I级创伤中心进行了回顾性单中心回顾,与1989年的汇总数据相比,确定2012-2019年和2020-2021年之间的所有手外伤咨询。
结果:车祸,枪声,锯伤,门受伤,与1989年相比,2012-2019年和2020-2021年的降幅有所增加,而刀伤,玻璃伤,工伤,烧伤减少。挤压伤,去手套伤,边缘不规则的撕裂伤在最近的队列中有所增加,与截肢和组织损失增加相对应。皮肤和皮下损伤在现代队列中减少,与原发性皮肤修复能力下降和需要更多皮瓣相对应。此外,虽然住院人数有所增加,患者的随访情况有所改善。
结论:在过去的三十年中,手外伤的性质发生了显著变化。汽车数量的增加和获得枪支的机会增加可能导致高能创伤的发生率增加,虽然烧伤和工业伤害有所减少,可能是提高安全工作的次要因素。尽管总体上手部创伤有所增加,治疗和随访时间有所改善。通过这项研究,我们可以更加认识到现代手部创伤的演变。这可以允许改善对护理的访问并进一步改进管理以优化手损伤的功能。
BACKGROUND: The purpose of this study is to evaluate any changes to hand trauma in the past three decades and through the COVID-19 pandemic. We hypothesized that improved consumer safety regulations, changes in access to care, and the impact of a global pandemic, among other variables, have significantly influenced the mechanisms and treatment of hand injuries between the 1980s, 2010s (pre-COVID-19), and 2020s (post-COVID-19).
METHODS: A retrospective single-center review was performed at the only level I trauma center in Mississippi, identifying all hand trauma consultations between 2012-2019 and 2020-2021, compared to aggregated data from 1989.
RESULTS: Car accidents, gunshots, saw injuries, door injuries, and falls increased in 2012-2019 and 2020-2021 compared to 1989, whereas knife injuries, glass injuries, industrial injuries, and burns decreased. Crush injuries, de-gloving injuries, and lacerations with irregular edges were increased in recent cohorts, corresponding with increased amputations and tissue loss. Skin and subcutaneous injuries decreased in modern cohorts, corresponding with a decreased ability for primary skin repair and the need for more flaps. Additionally, while hospitalizations have increased, patients have improved follow-up.
CONCLUSIONS: The nature of hand trauma has changed significantly over the past three decades. Increased numbers of cars and greater access to firearms might have led to increased rates of high-energy trauma, whereas burn and industrial injuries have decreased, potentially secondary to improved safety efforts. Despite increased overall hand trauma, time to treatment and follow-up have improved. Through this study, we can be more cognizant of the evolution of hand trauma in the modern era. This can allow improved access to care and further refine management to optimize functionality for hand injuries.