What kinds of hand injuries are more likely to result in amputation? An analysis of 6549 hand injuries
In order to guide preventive measures, the aim of this study was to define the risk factors for hand amputations using the records of a hospital in Turkey specializing in hand and microsurgery. It examined over 6.5k hand injuries and reveals that left-handed individuals had a five times greater relative risk of sustaining an amputating injury than right-handed individuals. This study found the age groups 15–24 and 45–54 were most at risk. Human factors such as reflex time, inattention, fatigue, medication use or alcohol use must be investigated to explain the increased rate of injury within those groups. Paid work was confirmed as the most frequent and risky activity, Compared to home, commercial areas were the places with highest risk). An important reason seems to be the use of meat-grinders which are among the top ten objects involved, both for men and women.
The paper concludes that injuries causing amputations are still a significant problem in Turkey. The unemployment rate and the ratio of workers without any social security are quite high and government control is insufficient in some workplaces. Workers have to work in worse conditions under the pressure of job insecurity. The ‘3 Es’ of prevention – education, enforcement, and improved engineering – should be implemented especially in industrial or construction areas to prevent amputations. Precluding illegal child labour is essential to prevent amputations in children.
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.
Durusoy, R., Davas, A., Kayalar, M., Bal, E., Aksu, F., & Ada, S. (2011). What kinds of hand injuries are more likely to result in amputation? An analysis of 6549 hand injuries Journal of Hand Surgery (European Volume), 36 (5), 383-391 DOI: 10.1177/1753193411400520