What kinds of hand injuries are more likely to result in amputation? An analysis of 6549 hand injuries

Abstract

We analysed 6549 hand injuries treated between 1992 and 2005 at a specialist hospital in Turkey to identify risk factors for amputations. There were 2899 (44%) hand amputations. Left-side injuries were more prone to amputation. The risk of amputation was higher in men, workers and those in the 15–24 and 45–54 year-old age groups. Compared to home, commercial areas were the places with highest risk, followed by farms and industrial/construction areas. The majority of amputations occurred in industrial/construction areas (87%). Among objects/substances producing injury, watercraft led to the highest risk of amputation and contact with machinery was the mechanism with highest risk. Press machines were the most frequent objects causing amputation both in men and women, followed almost equally by powered wood cutters in men. Doors were the most frequent objects of amputation in children, followed by powered wood cutters. Education, enforcement, and improved engineering are the keys to prevent amputations. Precluding illegal child labour is essential.

Keywords

Hand injury amputation risk factor activity object/substance mechanism

Get full access to this article

View all access options for this article.

References

Bakirci

. Child labour and legislation in Turkey. Int J Child Right. 2002, 10: 55–72.

Bilir

Yıldız

. Çalışma Hayatında Çocuk (Children in Working Life). In: İş Sağlığı ve İş Güvenliği (Occupational health and safety). Ankara: Hacettepe University Press, 2004, 111–26.

Boyle

Larson

Parker

. Medical, personal, and occupational outcomes for work-related amputations in Minnesota. Am J Ind Med. 2000a, 37: 551–7.

Boyle

Parker

Larson

. Nature, incidence, and cause of work-related amputations in Minnesota. Am J Ind Med. 2000b, 37: 542–50.

Cantürk

Esiyok

Yasar

. Evaluation of occupational injury cases in the department of Forensic Medicine, Ankara University Medical Faculty between 1993–2003. Erciyes Med J. 2006, 28: 1–6.

Conn

Annest

Ryan

. Non-work-related finger amputations in the United States, 2001–2002. Ann Emerg Med. 2005, 45: 630–5.

Conn

Rabi

Al-Homran

. Occupational permanent disabilities reported to the social security corporation in Jordan. Safety Sci. 1996, 24: 111–19.

Davas Aksan

Durusoy

Ada

. Epidemiology of injuries treated at a hand and microsurgery hospital between 1992–2005. Acta Orthop Traumatol Turc. 2010, 44: 352–360.

Dillingham

Pezzin

MacKenzie

. Incidence, acute care length of stay, and discharge to rehabilitation of traumatic amputee patients: an epidemiologic study. Arch Phys Med Rehabil. 1998, 79: 279–87.

10.

Dillingham

Pezzin

MacKenzie

. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002, 95: 875–83.

11.

Dogan

Sungur

Bilgic

. Amputations in eastern Turkey (Van): A multicenter epidemiological study. Acta Orthop Traumatol Turc. 2008, 42: 53–8.

12.

Freeland

Psonak

. Traumatic below-elbow amputations. Orthopedics. 2007, 30: 120–6.

13.

Grob

Papadopoulos

Zimmermann

. The psychological impact of severe hand injury. J Hand Surg Eur. 2008, 33: 358–62.

14.

Hart

. Hand injury prevention. Ann Emerg Med. 2005, 45: 636–8.

15.

Hoxie

Capo

Dennison

. The economic impact of electric saw injuries to the hand. J Hand Surg Am. 2009, 34: 886–9.

16.

ICECI Coordination and Maintenance Group. International Classification of External Causes of Injuries (ICECI) version 1.2. Consumer Safety Institute, Amsterdam and AIHW National Injury Surveillance Unit. Adelaide. 2004, 21–134.

17.

Liang

Chen

Hsu

. Work-related upper limb amputations in Taiwan, 1999–2001. Am J Ind Med. 2004, 46: 649–55.

18.

Lindqvist

Gerdin

. Hand injury from powered wood splitters. Scand J Plast Reconstr Surg Hand Surg. 2008, 42: 246–52.

19.

McCall

Horwitz

. An assessment and quantification of the rates, costs, and risk factors of occupational amputations: Analysis of Kentucky Workers’ Compensation Claims, 1994–2003. Am J Ind Med. 2006, 49: 1031–8.

20.

Moini

Rasouli

Khaji

. Patterns of extremity traumas leading to amputation in Iran: results of Iranian National Trauma Project. Chin J Traumatol. 2009, 12: 77–80.

21.

Olson

Gerberich

. Traumatic amputations in the workplace. J Occup Med. 1986, 28: 480–5.

22.

Serinken

Karcioglu

Sener

. Occupational hand injuries treated at a tertiary care facility in Western Turkey. Ind Health. 2008, 46: 239–46.

23.

Stanbury

Reilly

Rosenman

. Work-related amputations in Michigan, 1997. Am J Ind Med. 2003, 44: 359–67.

24.

Taras

Behrman

Degnan

. Left-hand dominance and hand trauma. J Hand Surg Am. 1995, 20: 1043–6.

25.

Trybus

Lorkowski

Brongel

. Causes and consequences of hand injuries. Am J Surg. 2006, 192: 52–7.

26.

Turkish Statistical Institute. Household labour force survey results. Press Release of Turkish Statistical Institute. 2010, 84: 2–2.