Document NNey8zBxqm6XZGBmpVQmZRV4p

FLAX--REHABILITATION OF HAND INJURIES 243 Commissioners are deducted, the remaining 30 represent 3.6 per cent of the 814 who had hand injuries. It is of interest to note that the decrease in incapacity from the date of admission to the Department of Physical Medicine and Rehabilitation to that of discharge from the Industrial Commission with the final rating was 17.8 per cent. Nevertheless, the average increase in disability rating over that granted by the Medical Division of State Insurance Fund was 5.8 per cent. The average age of the laborer in this group was 39 years, and he did not receive any physical medicine treatment until 6.3 weeks after the accidents. BbS- SUMMARY During the fiscal year 1948-1949, there were registered 61,170 workers who had undergone accidents, and 37,057 received compensation, 2,017 of whom were referred and received physical medicine treatment. Of this number 814 laborers, or 40.3 per cent, had hand injuries, divided into 19 different diagnostic groups. All groups received daily massage and manipulation, usually both active and % passive movements. Occupational therapy, in the form of active and active-resistive hand classes, and corrective therapy, in the form of specific exercises and calis thenics, were prescribed. The length of treatment was four to six hours daily, five days per week. There were 65 patients, or 8.0 per cent of the total number, whose disability rating increased after treatment in the Department of Physical Medicine and Rehabilitation. There were 30, or 3.6 per cent of the total, who appealed successfully to the Industrial Commission. They received an increase of approximately 5.8 per cent over the disability fixed by the Medical Division of the State Insurance Fund. The average age of the patients was 35.6 years. On the average, patients waited 5.2 weeks before being referred for treatment to the Center.. Incapacity was reduced, on the average, from 33.45 to 15.5 per cent of the hand by the wrist in approximately 17 physical therapy and 18 occupational therapy treatment days. The cost of rehabilitating a hand injury, exclusive of compensation, was, on the avferage, $4.45 per day', or $77.88 per treatment period. The State Insurance Fund of Puerto Rico economized to the extent of $251.53 per case, or $204,745.42 on these 814 patients. This is attributed solely to providing the injured workmen with a complete surgical and medical program, including modern methods of physical medicine and rehabilitation. In-the preparation of this article, constructive criticism and assistance were received from Dr. Steven M. Horvath, associate professor of physiology, of the State University of Iowa College of Medicine, and Dr. George M. Piersol, professor of physical medicine and rehabili tation, of the University of Pennsylvania Graduate School of Medicine. DISCUSSION Dr. Henry C. Marble, Boston: Such reviews as this by Dr. Flax are valuable in many ways: They furnish a continuing check on the quality of medical,care. They point out the necessity of a competent follow-up as a part of a medical program, HI) I \i It ,! 1.: >; v !,, u V