Tariq Mahmood Rehan, Manzoor Ahmad Gill, Mansoor Aqil, Qazi Masroor Ali, Anjum Suhail.
Is it a diabetic hand?.
J Surg Pak Jan ;7(3):12-6.

This is a prospective study conducted in the department of surgery from 1-04-1999 to 31-012002 at BVH Bahawalpur. All the diabetic patients of both types (IDDM or NIDDM) of any age or sex, suffering from infection of hand or Foot were included in the study. A total of 36 diabetic patients had hand infection (Group A) as compared to 207 patients with Diabetic Foot (Group B). Average age of the patients in Group A was 39.6 years which was quite younger as compare to 57.5 years in Group B. Pain was the dominant presenting complaint (100%) in Group A patients. All these patients were manual workers (Tailors, Carpenters, Farmers, Blacksmiths, Embroidery workers or Housewives) and had minor trauma to their digits during work; which they had neglected for few days or received first aid treatment from a family member or quack. In Hand Group, no patient was in Grade 0, I, or III. During the course of treatment, all the patients (100%) of Hand Group required amputation of one or more digits of the dominant hand including amputation of the thumb in 22 patients. No patient required amputation of the whole hand or forearm. The involvement of thumb or index finger alone or along with other digits in almost all the patients of Hand Group, reflects their common use, in manual work and their more susceptibility to repeated minor trauma. The loss of thumbs in 22 patients reflected high morbidity in terms of loss of hand function though thumb reconstruction is a valid option. Morbidity in terms of hospital stay was quite less in Hand Group but it was 100% in terms of loss of crafted digits. Mortality in Hand Group patients was nil in contrast to 9(4.3%) in the Foot Group. Infection of the hand in Diabetics can be named as DIABETIC HAND without any ambiguity. This can lead to opening up of new era of research for better management of this entity in terms of DIABETIC HAND CLINICS. Surgical management of infection in diabetics should be early, aggressive and specialized to avoid poor outcome in the form of loss of vital craft hand.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com