Öz
Background: Hand and wrist injuries account for approximately 10% of all emergency department admissions. It has been shown that hand trauma, especially hand fractures are associated with social deprivation except for the very young and old. This study was aimed to evaluate the clinical characteristics, risk factors, and the effect of injury on the life of the patients admitted to the emergency department with an isolated hand injury.
Materials and Methods: The patients who admitted to the emergency department due to an isolated hand injury between 1 November 2019 and 1 November 2020 were included in the study. The multivariate logistic regression analysis was used to determine the risk factors of permanent disability.
Results: 205 patients were included in the study with a mean age of 28.05 ± 10.85 years and 142 (69.3%) of them were male. The vast majority of patients (n = 149, 72.7%) were in the 18-35 years age group. The mechanism of injury was blunt trauma in 131 (63.9%) patients and penetrating trauma in 65 (31.7%) patients. Amputation was observed in 25 (12.2%) patients and 20 (9.8%) patients had a permanent disability. Logistic regression analysis revealed that male sex and penetrating traumas were found to be independent risk factors for permanent disability (p = 0.012 and p < 0.001, respectively).
Conclusions: Evaluation of hand injuries and related factors in our region is important due to lifestyle and working condition differences. In our region, male gender and penetrating injuries are independent risk factors for isolated hand injuries. We think that the measures to be taken to prevent the occurrence of such injuries will decrease the permanent disability and related mental and economic burden.
Anahtar Kelimeler
Emergency department home accident isolated hand injury night shift occupational injury
Kaynakça
- 1. Abebe MW. Common causes and types of hand injuries and their pattern of occurrence in Yekatit 12 Hospital, Addis Ababa, Ethiopia. Pan Afr Med J. 2019;33:142.
- 2. Ihekire O, Salawu SA, Opadele T. International surgery: causes of hand injuries in a developing country. Can J Surg. 2010;53(3):161-6.
- 3. Şahin F, Akca H, Akkaya N, Zincir ÖD, Işik A. Cost analysis and related factors in patients with traumatic hand injury. J Hand Surg Eur Vol. 2013;38(6):673-9.
- 4. Rosberg HE, Carlsson KS, Dahlin LB. Prospective study of patients with injuries to the hand and forearm: costs, function, and general health. Scand J Plast Reconstr Surg Hand Surg. 2005;39(6):360-9.
- 5. Horton TC, Dias JJ, Burke FD. Social deprivation and hand injury. J Hand Surg Eur Vol. 200732(3):256-61.
- 6. Larsen CF, Mulder S, Johansen AM, Stam C. The epidemiology of hand injuries in The Netherlands and Denmark. Eur J Epidemiol. 2004;19(4):323-7.
- 7. Trybus M, Lorkowski J, Brongel L, Hladki W. Causes and consequences of hand injuries. Am J Surg. 2006;192(1):52-7.
- 8. Bhatti DS, Ain NU, Fatima M. Occupational Hand-Related Injuries at a Major Tertiary Care Burn and Reconstructive Center in Pakistan. Cureus. 2020;12(9):e10444.
- 9. Chow CY, Lee H, Lau J, Yu IT. Transient risk factors for acute traumatic hand injuries: a case-crossover study in Hong Kong. Occup Environ Med. 2007;64(1):47-52.
- 10. Gupta A, Gupta AK, Uppal SK, Mittal RK, Garg R, Aggarwal N. Demographic profile of hand injuries in an industrial town of north India: a review of 436 patients. Indian J Surg. 2013;75(6):454-61.
- 11. de Putter CE, van Beeck EF, Polinder S, Panneman MJ, Burdorf A, Hovius SE, et al. Healthcare costs and productivity costs of hand and wrist injuries by external cause: A population-based study in working-age adults in the period 2008-2012. Injury. 2016;47(7):1478-82.
- 12. De Sousa A, Sonavane S, Kurvey A, Kukreja S, Shah N. Psychological issues in hand trauma. Asian J Psychiatr. 2013;14(1):3-14.
- 13. Olaitan P, Oseni G, Olakulehin O. Pattern of hand injuries in osogbo, South-west Nigeria. J West Afr Coll Surg. 2011;1(3):15-25.
- 14. Ootes D, Lambers KT, Ring DC. The epidemiology of upper extremity injuries presenting to the emergency department in the United States. Hand. 2012;7(1):18-22.
- 15. Aslan A, Aslan İ, Özmeriç A, Atay T, Çaloğlu A, Konya MN. Acil El Yaralanmalarında Deneyimlerimiz: 5 Yıllık Verilerin Epidemiyolojik Değerlendirmesi. TAF Preventive Medicine Bulletin. 2013;12(5):563-70.
- 16. Oğuz AB, Polat O, Günalp M, Aygün Z, Genç S. Acil Servise Bașvuran El ve El Bileği Yaralanmalı Hastaların Maliyetlerinin İncelenmesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70(3):195-9.
- 17. Şakrak T, Mangır S, Körmutlu A, Cemboluk Ö, Kıvanç Ö, Tekgöz A. 1205 El Yaralanmasi Olgusunun Retrospektif Analizi. Türk Plastik, Rekonstrüktif ve Estetik Cerrahi Dergisi (Turk J Plast Surg). 2010;17(3):134-8.
- 18. Pomares G, Coudane H, Dap F, Dautel G. Epidemiology of traumatic upper limb amputations. Orthop Traumatol Surg Res. 2018;104(2):273-6.
- 19. Ma Z, Guo F, Qi J, Xiang W, Zhang J. Effects of non-surgical factors on digital replantation survival rate: a meta-analysis. J Hand Surg Eur Vol. 2016;41(2):157-63.
- 20. Bhat AK, Acharya AM, Narayanakurup JK, Kumar B, Nagpal PS, Kamath A. Functional and cosmetic outcome of single-digit ray amputation in hand. Musculoskelet Surg. 2017;101(3):275-81.
- 21. Robinson LS, O'Brien L. Description and cost-analysis of emergency department attendances for hand and wrist injuries. Emerg Med Australas. 2019;31(5):772-9.
Öz
Amaç: El ve el bileği yaralanmaları, tüm acil servis başvurularının yaklaşık %10'unu oluşturmaktadır. El travmalarının, özellikle el kırıklarının çok genç ve yaşlılar dışında sosyal yoksunluk ile ilişkili olduğu gösterilmiştir. Bu çalışmada izole el yaralanması ile acil servise başvuran hastaların klinik özellikleri, risk faktörleri ve yaralanmanın yaşam üzerindeki etkisinin değerlendirilmesi amaçlandı.
Materyal ve Method: 1 Kasım 2019 ile 1 Kasım 2020 tarihleri arasında izole el yaralanması nedeniyle acil servise başvuran hastalar çalışmaya dahil edildi. Kalıcı engellilik durumunun risk faktörlerini belirlemek için çok değişkenli lojistik regresyon analizi kullanıldı.
Bulgular: Çalışmaya ortalama yaşı 28,05 ± 10,85 yıl olan 205 hasta dahil edildi ve bunların 142'si (%69,3) erkekti. Hastaların büyük çoğunluğu (n = 149, %72,7) 18-35 yaş grubundaydı. Yaralanma mekanizması 131 (%63,9) hastada künt, 65 (%31,7) hastada penetran travmaydı. 25 (%12,2) hastada amputasyon, 20 (%9,8) hastada kalıcı engellilik durumu gözlendi. Lojistik regresyon analizi, erkek cinsiyet ve penetran travmaların kalıcı engellilik durumu için bağımsız risk faktörleri olduğunu gösterdi (p = 0,012 ve p < 0,001).
Sonuç: Bölgemizdeki el yaralanmaları ve ilişkili faktörlerin değerlendirilmesi, yaşam tarzı ve çalışma koşulları farklılıkları nedeniyle önemlidir. Çalışmamızın sonuçları erkek cinsiyet ve penetran yaralanmaların izole el yaralanmalarında kalıcı engellilik durumu için için bağımsız risk faktörleri olduğunu göstermiştir. Bu tür yaralanmaların oluşmasını önlemek için alınacak önlemlerin kalıcı engellilik durumunu ve buna bağlı ruhsal ve ekonomik yükü azaltacağını düşünüyoruz.
Anahtar Kelimeler
Acil servis ev kazası gece vardiyası iş kazası izole el yaralanması
Kaynakça
- 1. Abebe MW. Common causes and types of hand injuries and their pattern of occurrence in Yekatit 12 Hospital, Addis Ababa, Ethiopia. Pan Afr Med J. 2019;33:142.
- 2. Ihekire O, Salawu SA, Opadele T. International surgery: causes of hand injuries in a developing country. Can J Surg. 2010;53(3):161-6.
- 3. Şahin F, Akca H, Akkaya N, Zincir ÖD, Işik A. Cost analysis and related factors in patients with traumatic hand injury. J Hand Surg Eur Vol. 2013;38(6):673-9.
- 4. Rosberg HE, Carlsson KS, Dahlin LB. Prospective study of patients with injuries to the hand and forearm: costs, function, and general health. Scand J Plast Reconstr Surg Hand Surg. 2005;39(6):360-9.
- 5. Horton TC, Dias JJ, Burke FD. Social deprivation and hand injury. J Hand Surg Eur Vol. 200732(3):256-61.
- 6. Larsen CF, Mulder S, Johansen AM, Stam C. The epidemiology of hand injuries in The Netherlands and Denmark. Eur J Epidemiol. 2004;19(4):323-7.
- 7. Trybus M, Lorkowski J, Brongel L, Hladki W. Causes and consequences of hand injuries. Am J Surg. 2006;192(1):52-7.
- 8. Bhatti DS, Ain NU, Fatima M. Occupational Hand-Related Injuries at a Major Tertiary Care Burn and Reconstructive Center in Pakistan. Cureus. 2020;12(9):e10444.
- 9. Chow CY, Lee H, Lau J, Yu IT. Transient risk factors for acute traumatic hand injuries: a case-crossover study in Hong Kong. Occup Environ Med. 2007;64(1):47-52.
- 10. Gupta A, Gupta AK, Uppal SK, Mittal RK, Garg R, Aggarwal N. Demographic profile of hand injuries in an industrial town of north India: a review of 436 patients. Indian J Surg. 2013;75(6):454-61.
- 11. de Putter CE, van Beeck EF, Polinder S, Panneman MJ, Burdorf A, Hovius SE, et al. Healthcare costs and productivity costs of hand and wrist injuries by external cause: A population-based study in working-age adults in the period 2008-2012. Injury. 2016;47(7):1478-82.
- 12. De Sousa A, Sonavane S, Kurvey A, Kukreja S, Shah N. Psychological issues in hand trauma. Asian J Psychiatr. 2013;14(1):3-14.
- 13. Olaitan P, Oseni G, Olakulehin O. Pattern of hand injuries in osogbo, South-west Nigeria. J West Afr Coll Surg. 2011;1(3):15-25.
- 14. Ootes D, Lambers KT, Ring DC. The epidemiology of upper extremity injuries presenting to the emergency department in the United States. Hand. 2012;7(1):18-22.
- 15. Aslan A, Aslan İ, Özmeriç A, Atay T, Çaloğlu A, Konya MN. Acil El Yaralanmalarında Deneyimlerimiz: 5 Yıllık Verilerin Epidemiyolojik Değerlendirmesi. TAF Preventive Medicine Bulletin. 2013;12(5):563-70.
- 16. Oğuz AB, Polat O, Günalp M, Aygün Z, Genç S. Acil Servise Bașvuran El ve El Bileği Yaralanmalı Hastaların Maliyetlerinin İncelenmesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70(3):195-9.
- 17. Şakrak T, Mangır S, Körmutlu A, Cemboluk Ö, Kıvanç Ö, Tekgöz A. 1205 El Yaralanmasi Olgusunun Retrospektif Analizi. Türk Plastik, Rekonstrüktif ve Estetik Cerrahi Dergisi (Turk J Plast Surg). 2010;17(3):134-8.
- 18. Pomares G, Coudane H, Dap F, Dautel G. Epidemiology of traumatic upper limb amputations. Orthop Traumatol Surg Res. 2018;104(2):273-6.
- 19. Ma Z, Guo F, Qi J, Xiang W, Zhang J. Effects of non-surgical factors on digital replantation survival rate: a meta-analysis. J Hand Surg Eur Vol. 2016;41(2):157-63.
- 20. Bhat AK, Acharya AM, Narayanakurup JK, Kumar B, Nagpal PS, Kamath A. Functional and cosmetic outcome of single-digit ray amputation in hand. Musculoskelet Surg. 2017;101(3):275-81.
- 21. Robinson LS, O'Brien L. Description and cost-analysis of emergency department attendances for hand and wrist injuries. Emerg Med Australas. 2019;31(5):772-9.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Nisan 2021 |
| Gönderilme Tarihi | 21 Şubat 2021 |
| Kabul Tarihi | 7 Nisan 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 18 Sayı: 1 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty