Epidemiology of injuries treated at a hand and microsurgery hospital

Objectives: The aim of this study was to evaluate the epidemiology of injuries treated at a hand and microsurgery hospital between 1992 and 2005. Methods: This is a descriptive retrospective study based on medical records of a hand and micro¬surgery hospital in izmir for the years 1992-2005. A total of 8,946 injuries involving 8,817 patients were included. Data on diagnosis were recorded according to ICD-10. Intent, activity when injured, mechanism of injury, object/substance producing injury, and place of injury were recoded according to International Classification of External Causes of Injury (ICECI). Results: The most common types of injury were amputations (32.3%), fractures (23.7%), and open wounds (19.9%) of the wrist and hand. Most injuries were sustained by males; 28.4% of injuries occurred during summer. According to activity, 76.3% were injured during paid work, 10.4% during transportation, 9.1% during unpaid work, and 3.8% during leisure time sports and exercise. Injuries most commonly occurred while operating a machine. The risk of hand injury was elevated in those younger than 35 years of age, males, persons outside izmir province, and in Social Security Instution (SSI) insured workers (p<0.001). The riskiest activity for hand injuries was paid work. Compared to baseline, the risk of hand injuries was 29 times [95% con¬fidence interval (CI) 16.36-50.40] as high in industrial or construction areas, and 50 times (95% CI 17.29-143.96) as high in commercial places. Conclusion: Hand injuries are important because of their consequences, such as permanent dis¬ability and their high treatment costs. This study points out many important risk factors, and has contributed the development of hypotheses about injury types, under-notification of occupation¬al injuries, and child labour. The inclusion of medical records from such specialized hospitals into national databases will aid in the prevention of these injuries, and induce developments in diagnosis and treatment.