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Graham EM, Baschuk CM, Atkins DJ, Hutchinson L, Duncan CC, Mendenhall SD. Hand Surgeons' Understanding of Partial Hand Prostheses: Results of a National Survey Study. Hand (N Y) 2023; 18:1156-1168. [PMID: 35081822 PMCID: PMC10798212 DOI: 10.1177/15589447211068185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Partial hand amputations are devastating injuries that often negatively affect individuals and communities. Partial hand prostheses can mitigate the burdens of living with an amputation, especially when reconstruction alone cannot restore form or function. However, hand surgeons may be unfamiliar with these newer devices because the prosthetic field is rapidly progressing. METHODS An electronic survey was distributed to hand surgeon members of the American Association for Hand Surgery with the intent of assessing surgeons' familiarity with partial hand prosthetic devices and their clinical applications. Survey items used Likert 5-point scales, rank order, multiple-choice, and yes/no question formats. Responses were compared by training background (orthopedic or plastic surgery) and by years of experience (≤10 years in practice or >10 years in practice). RESULTS Overall, hand surgeons are unfamiliar with modern partial hand prosthetic devices. Most of the cohort denied working within a multidisciplinary hand team (76.2%) or consulting with a prosthetist prior to revisional surgeries (71.4%). Restoring gross motor function and reducing pain were important outcomes to the cohort (4.42 and 4.17, respectively). Plastic trained hand surgeons were more likely to list toe-to-hand transfers as treatment options for multilevel digital amputations (P = .03) and transmetacarpal amputations (P = .02). Senior hand surgeons were more likely to suggest no treatment for partial thumb amputations (P = .02). CONCLUSIONS Expanding surgeon knowledge and encouraging collaboration within a multidisciplinary team may enhance amputee care.
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Affiliation(s)
- Emily M. Graham
- The Children’s Hospital of Philadelphia, PA, USA
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, USA
| | | | - Diane J. Atkins
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Lana Hutchinson
- Department of Occupational Hand Therapy, University of Utah, Salt Lake City, USA
| | - Christopher C. Duncan
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, USA
| | - Shaun D. Mendenhall
- The Children’s Hospital of Philadelphia, PA, USA
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, USA
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Hosseininejad M, Javadifar S, Mohammadi S, Mirzamohammadi E. Assessment of the relationship between the return to work and the severity of work-related upper limb injuries using the whole person impairment. Chin J Traumatol 2023; 26:77-82. [PMID: 36526509 PMCID: PMC10071318 DOI: 10.1016/j.cjtee.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 10/07/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Upper limb disorders are one of the most common and important types of occupational injuries. Besides, identifying the factors influencing return to work following these injuries is essential to reduce the dimensions of the problem. In this study, we investigated the return to work and associated factors following occupational injuries leading to upper limb impairment. METHODS In this retrospective cohort study, the rate of return to work and associated factors were assessed in 256 workers with work-related upper limb injury referred to a teaching hospital from March 2011 to December 2018. The inclusion criterion was a history of occupational injury resulting in upper limb impairment, and exclusion criteria included the presence of simultaneous impairment in other organs, congenital or non-occupational limb defects as well as patients with incomplete information in their medical records. Individuals' records, including age at the time of injury, gender, date of injury, marital status, education, level of amputation and injury, whole person impairment (WPI) and physiotherapy (prescribed by the physician) were reviewed. The WPI was calculated to assess the extent of the injury. All analyzes were performed by SPSS version 25.0. RESULT The rate of return to work was 54.3%, in which 51.8% for the same job and 48.2% for a new job. The main factors associated with non-return to work were more days off work (p = 0.001), higher injury severity (p = 0.001), and dominant hand injury (p = 0.034). CONCLUSION The number of days off work, the WPI, and dominant hand injury are the most important determinant in returning to work. In addition, increased job satisfaction and support from co-workers and employers are work-related factors that can lead to an increased return to work.
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Affiliation(s)
- Mahin Hosseininejad
- Occupational Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Javadifar
- Occupational Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saber Mohammadi
- Occupational Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Mirzamohammadi
- Occupational Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Easing the financial burden on upper limb amputees: Grants to support academics and quality of life in North America. J Plast Reconstr Aesthet Surg 2023; 76:142-144. [PMID: 36516505 DOI: 10.1016/j.bjps.2022.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
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Buchanan H, Van Niekerk L, Grimmer K. Work transition after hand injury: A scoping review. J Hand Ther 2022; 35:11-23. [PMID: 33250399 DOI: 10.1016/j.jht.2020.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/20/2020] [Accepted: 10/09/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic scoping review. INTRODUCTION Many factors are potentially associated with successful work-related transitions following hand injury. There is no current, comprehensive review of the literature to guide clinical practice. PURPOSE OF THE STUDY To comprehensively identify the current body of research evidence supporting return to work (RTW) after hand injury and identify gaps. METHODS A systematic search identified relevant, peer-reviewed, full text, English language primary qualitative or quantitative literature published since 2006. All authors independently determined whether studies should be included, assigned them to a hierarchy of evidence and extracted data. Decisions were defended and disagreements resolved in team meetings. Literature was summarized into key themes using common intent and constructs. RESULTS Of 259 potentially-relevant articles, 38 were relevant. Study designs included prospective observational, cross-sectional, and retrospective (n=9 each), mixed methods (n=3), qualitative (n=4), and opinion pieces (n=4). There were no experimental studies. The most commonly-reported key themes were prognostic factors for RTW (25 papers) and assessment tools (18 papers). Remaining themes of impact of injury on the individual, patient perspectives, other stakeholder perspectives, healthcare provider education, and treatment were reported in fewer than 10 papers each. There was little commonality in how research was conducted or reported. Gaps included lack of information on effective interventions, which prognostic factors should be routinely measured, and which assessment and outcome items to routinely use in practice. CONCLUSION Despite the impact of hand injury on capacity to RTW, there is limited evidence to inform successful work-related transitions.
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Affiliation(s)
- Helen Buchanan
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Lana Van Niekerk
- Division of Occupational Therapy, Department of Health and Rehabilitation Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Karen Grimmer
- Division of Physiotherapy, Department of Health and Rehabilitation Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
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Bae SW, Jeong I, Yoon JH, Lee SW, Kim TH, Won JU. Relationship between workers' return to work, job retention and income in industrial accidents in Korea: a longitudinal study. BMJ Open 2021; 11:e039948. [PMID: 33837092 PMCID: PMC8043011 DOI: 10.1136/bmjopen-2020-039948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study aims to compare workers' income before and after an occupational injury, with regard to return to work and job retention, over a period of 5 years. DESIGN This study was designed as a longitudinal study. SETTING The Panel Study of Workers' Compensation Insurance (PSWCI) survey targeted workers involved in industrial accidents for which medical care was terminated in the year 2012. PARTICIPANTS The panel study was conducted on a final sample of 2000 workers who were selected proportionally by region (nine regions) after priority assignment by disability rating (six levels). A total of 1458 workers were finally included in this study. METHODS This study used data from the first to fifth PSWCI. To identify the effect on income after occupational injury considering return to work and job retention, we used the generalised estimating equation. RESULTS In regard to workers' return to work, the OR that income after an occupational injury would be higher than that before an occupational injury was 3.17 (2.41-4.17) for those who returned to original work and 2.32 (1.81-2.97) for those re-employed as compared with who did not return to work and 1.27 (1.07-1.15) for those who retained their job as compared with those who did not. The ORs were 2.91 (2.26-3.75) for those who were re-employed and retained jobs and 2.96 (2.15-4.08) for those who returned to original work and did not retain jobs as compared with those who did not return to work and did not retain jobs. CONCLUSIONS It is important for accident victims to retain their jobs to maintain their economic status.
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Affiliation(s)
- Suk Won Bae
- Graduate School of Public Health, Yonsei University, Seoul, South Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
| | - Inchul Jeong
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - Jin-Ha Yoon
- Graduate School of Public Health, Yonsei University, Seoul, South Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
- Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Wook Lee
- Labor Welfare Research Institute, Korea Workers' Compensation & Welfare Service, Seoul, South Korea
| | - Tae Hyun Kim
- Department of Hospital Administration, Graduate School of Public Health, Yonsei University, Seoul, South Korea
- Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Jong-Uk Won
- Graduate School of Public Health, Yonsei University, Seoul, South Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
- Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, South Korea
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Graham EM, Hendrycks R, Baschuk CM, Atkins DJ, Keizer L, Duncan CC, Mendenhall SD. Restoring Form and Function to the Partial Hand Amputee: Prosthetic Options from the Fingertip to the Palm. Hand Clin 2021; 37:167-187. [PMID: 33198915 DOI: 10.1016/j.hcl.2020.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Partial hand amputations are the most common upper extremity amputations and affect individuals across a spectrum of socioeconomic and geographic backgrounds. Prosthetic devices can provide straightforward solutions to the devastating aesthetic, functional, psychological, and social deficits caused by these injuries. However, because of the recent development of multiple partial hand prosthetic devices, many hand providers remain unaware of their applicability in practice. This article highlights the various classes of partial hand prostheses currently available, including passive functional, body-powered, and externally powered options. Familiarity with these partial hand prostheses will better enable providers to care for partial hand amputees.
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Affiliation(s)
- Emily M Graham
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East Room 3B400, Salt Lake City, UT 84132, USA
| | - Russell Hendrycks
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East Room 3B400, Salt Lake City, UT 84132, USA
| | | | - Diane J Atkins
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Lana Keizer
- Department of Occupational Hand Therapy, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Christopher C Duncan
- Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA; Craig H. Neilsen Rehabilitation Hospital, 85 North Medical Drive, Salt Lake City, UT 84132, USA
| | - Shaun D Mendenhall
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East Room 3B400, Salt Lake City, UT 84132, USA.
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Izadi N, Jamshidi S, Mehrdad R, Nasibi E. Predictors of return to work in patients with occupational hand injury. HAND SURGERY & REHABILITATION 2020; 39:218-222. [PMID: 32112867 DOI: 10.1016/j.hansur.2020.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 01/19/2023]
Abstract
Work-related hand injuries are the primary cause of disability and prolonged time away from work. This prospective cohort study was conducted to determine the predictors of return to work (RTW) after traumatic work-related hand injuries. Our study included 280 patients who were referred to the Plastic and Reconstructive Center for treatment of their occupational hand injuries from July 2017 to February 2018. Several functional questionnaires were completed, and they were followed up at 1, 3 and 8 weeks. Telephone interviews were done 3 months later. Approximately half the subjects had returned to work during the first 3 months after a median time away of 57 days. No relationship was found between age, gender, marital status, hand dominance and RTW time. Nevertheless, there was correlation between RTW time with cigarette smoking, injury severity and disability. Our study findings suggest that injury severity and higher work disability scores are prognostic factors for RTW. Also, smoking was associated with later RTW, which could be the result of poor circulation and delayed healing. Employers should implement injury prevention programs with appropriate rehabilitation that takes into consideration the severity of the hand injury, and health strategies to improve unhealthy lifestyle factors such as smoking.
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Affiliation(s)
- N Izadi
- Center for Research on Occupational Disease, Tehran University of Medical Sciences, No. 226, Qods Street, Keshavarz Boulevard, 1416753955 Tehran, Iran.
| | - S Jamshidi
- Plastic and reconstructive surgery, Iran University of Medical Sciences, Tehran Hemat Highway next to Milad Tower 14496, 14535 Tehran, Iran.
| | - R Mehrdad
- Center for Research on Occupational Disease, Tehran University of Medical Sciences, No. 226, Qods Street, Keshavarz Boulevard, 1416753955 Tehran, Iran.
| | - E Nasibi
- Center for Research on Occupational Disease, Tehran University of Medical Sciences, No. 226, Qods Street, Keshavarz Boulevard, 1416753955 Tehran, Iran.
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Aman M, Bergmeister KD, Festin C, Sporer ME, Russold MF, Gstoettner C, Podesser BK, Gail A, Farina D, Cederna P, Aszmann OC. Experimental Testing of Bionic Peripheral Nerve and Muscle Interfaces: Animal Model Considerations. Front Neurosci 2020; 13:1442. [PMID: 32116485 PMCID: PMC7025572 DOI: 10.3389/fnins.2019.01442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/23/2019] [Indexed: 12/05/2022] Open
Abstract
Introduction: Man-machine interfacing remains the main challenge for accurate and reliable control of bionic prostheses. Implantable electrodes in nerves and muscles may overcome some of the limitations by significantly increasing the interface's reliability and bandwidth. Before human application, experimental preclinical testing is essential to assess chronic in-vivo biocompatibility and functionality. Here, we analyze available animal models, their costs and ethical challenges in special regards to simulating a potentially life-long application in a short period of time and in non-biped animals. Methods: We performed a literature analysis following the PRISMA guidelines including all animal models used to record neural or muscular activity via implantable electrodes, evaluating animal models, group size, duration, origin of publication as well as type of interface. Furthermore, behavioral, ethical, and economic considerations of these models were analyzed. Additionally, we discuss experience and surgical approaches with rat, sheep, and primate models and an approach for international standardized testing. Results: Overall, 343 studies matched the search terms, dominantly originating from the US (55%) and Europe (34%), using mainly small animal models (rat: 40%). Electrode placement was dominantly neural (77%) compared to muscular (23%). Large animal models had a mean duration of 135 ± 87.2 days, with a mean of 5.3 ± 3.4 animals per trial. Small animal models had a mean duration of 85 ± 11.2 days, with a mean of 12.4 ± 1.7 animals. Discussion: Only 37% animal models were by definition chronic tests (>3 months) and thus potentially provide information on long-term performance. Costs for large animals were up to 45 times higher than small animals. However, costs are relatively small compared to complication costs in human long-term applications. Overall, we believe a combination of small animals for preliminary primary electrode testing and large animals to investigate long-term biocompatibility, impedance, and tissue regeneration parameters provides sufficient data to ensure long-term human applications.
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Affiliation(s)
- Martin Aman
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Division of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Konstantin D Bergmeister
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Division of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Christopher Festin
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Matthias E Sporer
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Division of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | | | - Clemens Gstoettner
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Bruno K Podesser
- Division of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Alexander Gail
- Cognitive Neuroscience Lab, German Primate Center, Göttingen, Germany
| | - Dario Farina
- Department of Bioengineering, Imperial College, London, United Kingdom
| | - Paul Cederna
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Oskar C Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
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