Related Experiment Video
Updated: Jul 13, 2026
07:28
A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
Hay baler injuries to the upper extremity
Tuna Ozyürekoğlu1, Margaret Napolitano, James M Kleinert
1Division of Hand Surgery, Department of Surgery, University of Louisville, School of Medicine, and Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky 40202, USA. tozyurekoglu@kkahand.com
The Journal of Trauma
|July 12, 2007
Summary
Severe hay baler injuries to the upper extremity often lead to poor outcomes, with initial tissue loss significantly impacting reconstruction and replantation success. Higher injury severity correlated with increased complications and reduced functional results.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Reconstructive Surgery
Background:
- Hay baler injuries to the upper extremity are uncommon and poorly documented.
- This study analyzes functional outcomes of various treatment methods for these injuries.
Purpose of the Study:
- To evaluate the functional results of reconstruction, replantation, or amputation following hay baler injuries.
- To correlate injury severity with treatment outcomes and complications.
Main Methods:
- Retrospective analysis of 21 patients with upper extremity hay baler injuries.
- Classification of injuries into five groups based on location, vascularity, and tissue loss.
- Functional assessment based on extremity usefulness.
Main Results:
- Patients averaged three procedures and 11.5 days hospitalization; 33% infection rate.
- Eleven good, four fair, and six poor functional results were observed.
- Increased injury severity correlated with higher infection rates, more procedures, longer hospital stays, and poorer outcomes.
Conclusions:
- Initial tissue loss is a key predictor of replantation success and functional outcome.
- Free tissue transfers and replantation showed potential benefits in select cases.
- Replantation with concurrent free tissue transfer in this series ultimately required revision amputation.
Related Concept Videos
01:19Bones of the Upper Limb: Humerus
The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
01:26Flail Chest-II
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
01:24Flail Chest-I
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:12Arteries of the Upper Limbs
The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
01:15Bones of the Upper Limb: Ulna
The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side of the...
01:29Herniated Intervertebral Disc l: Introduction
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...