title: Isolated hand injuries on operational deployment: an examination of epidemiology and treatment strategy.
abstract: This study presents an analysis of 6 years of isolated hand injuries repatriated from Afghanistan or Iraq. Of a total of 6,337 medical cases evacuated back to the United Kingdom, 414 (6.5%) cases were identified as hand injuries; from these exclusions were: 207 who did not return to Royal Centre for Defence Medicine, 12 who were incorrectly coded, 1 was an old injury, and 41 whose notes were unavailable. The notes of the remaining 153 patients were reviewed: only 9% had battle injuries; nearly half involved fractures; overall, 73% required surgery, a total of 171 surgical episodes, a third of these operations occurred in deployed facilities. Patients with primary nerve or tendon repairs in deployed medical facilities had a trend toward significantly worse outcomes than those whose primary repair was delayed until repatriation. This study supports the current recommendation of delaying tendon and nerve repair until repatriation.
authors.affiliation: Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, ICT Research Park, Vincent Drive, Birmingham B 15 2SQ, United Kingdom.
authors.forename: Jowan G
authors.initials: JG
authors.lastname: Penn-Barwell
authors.forename: Philippa M
authors.initials: PM
authors.lastname: Bennett
authors.forename: Dominic
authors.initials: D
authors.lastname: Powers
authors.forename: David
authors.initials: D
authors.lastname: Standley
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D006230:Hand Injuries / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D054542:Iraq War, 2003-2011; D008889:Military Personnel / Q000706:statistics & numerical data; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology