Does a trauma clinic help improve the diagnosis of soft tissue hand injuries?

Abstract

Soft tissue hand injuries represent a major part of the trauma workload in most plastic surgery units in the UK. It is therefore crucial that such injuries be appropriately assessed and managed, so as to reduce the risk of any potential complications. Also, inappropriate assessments may lead to unnecessary operations and their potential complications. In an attempt to improve its trauma service, the Plastic Surgery Unit at Frenchay Hospital has made several innovations to its service, one of which being the creation of a trauma clinic manned by a senior plastic registrar. The aim of our study was to assess the rate of negative exploration in soft tissue hand injuries and also to assess the impact that the trauma clinic will have on the diagnosis of soft tissue injuries. The pre- and post-operative diagnosis of 50 patients prospectively recruited from the pre- and post-trauma clinic were compared and analysed using the t test. The overall rate of negative exploration was 7% (8% pre-trauma clinic and 6% post-trauma clinic). The correct diagnosis was made in 68% in the pre-trauma clinic group and 74% in the post-trauma clinic group. Additional diagnoses were made in 24% and 20% of pre- and post-trauma groups, respectively. The seniority of the senior house officers also influenced the rate of accurate diagnosis.