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Factitious disorders in the hand-Main diagnostic traps highlighted with 3 cases
M Bachy1, A-H Moncany2, C Tournier3
1Service de chirurgie orthopédique et réparatrice, hôpital Trousseau, AP-HP, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
Hand Surgery & Rehabilitation
|January 3, 2018
Summary
Factitious disorder of the hand, where patients inflict injuries on themselves, is difficult to diagnose and often underestimated. Early detection and psychiatric involvement are crucial for effective management and to avoid unnecessary surgery.
Area of Science:
- Psychiatry
- Hand Surgery
- Medical Diagnosis
Background:
- Factitious disorder involves intentionally produced physical symptoms.
- The hand is a common site for self-inflicted injuries due to accessibility.
- Diagnosis is challenging, often overlooked, and requires early identification.
Observation:
- Presents three clinical cases highlighting diagnostic and therapeutic difficulties.
- Emphasizes the need to differentiate factitious disorder from malingering.
- Highlights the importance of a multidisciplinary team including psychiatrists.
Findings:
- Factitious disorders of the hand are recognized psychiatric conditions.
- Unusual injuries with vague histories should raise suspicion.
- Confirmation of diagnosis is essential to prevent inappropriate surgical intervention.
Implications:
- Early diagnosis and integrated treatment are vital for managing factitious disorder of the hand.
- Maintaining patient contact post-diagnosis is critical to prevent re-engagement with other professionals.
- Surgeons must consider factitious disorder in cases of unexplained hand injuries.
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