Aim The aim of this study was to identify risk factors for hand amputations using the records of a hospital in Turkey specialising in hand and microsurgery.
Method This is a restrospective analytical chart study. We analysed 6549 hand injuries treated between 1992 and 2005. Researchers coded the variables “intent”, “activity when injured”, “mechanism of injury”, “object/substance producing injury” and “place of occurrence” according to the International Classification of External Causes of Injuries (ICECI), 2004. χ2 Test and univariate logistic regression analyses were used to explore the effects of ICECI categories and gender, age, social security, residence, season on the presence of an amputation.
Results There were 2899 (44%) hand amputations and 2812 (97%) were finger amputations. Left-side injuries were more prone to amputation (OR=1.13, CI 1.03 to 1.25). 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 area was the place with highest risk (OR=4.06, CI 2.52 to 6.54), followed by farm (OR=3.64, CI 2.66 to 4.98) and industrial/construction area (OR=3.12, CI 2.55 to 3.82). The majority of amputations occurred in industrial/construction areas (87%). Among objects/substances producing injury, watercraft (OR=49.5, CI 6.2 to 394.9) led to the highest risk of amputation and contact with machinery (OR=9.04, CI 7.53 to 10.85) 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.
Conclusion Education, enforcement, and improved engineering are the keys to prevent amputations. Precluding illegal child labour is essential.
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