Traumatic Hand Injuries presenting to Orthopedic Unit of a Regional Referral Hospital, Oman

Abstract

Introduction: Hand is a prized component of human body with a unique function and structure. Any injury to this part can lead to significant disability. In the changing mechanized world we see more cases of hand injuries every day of varying patterns. A better understanding of such injuries can help us to identify those individuals at risk, plan proper management protocols and preventive measures in order to reduce the incidence and improve prognosis.

Methodology: This is a retrospective study conducted over period of 12 months (01/01/2018-31/12/2018) in which Ninety cases of hand injuries who presented to our department were included. The clinical notes of these patients were reviewed from the hospital computerized patient data and all relevant information was recorded in the predesigned perform as regards demographic data, occupation place, causes, pattern of injury, and treatment done. HISS (Hand injury severity score) was used for assessment of final functional outcome after analysis of all variables.

Results: Ninety patients (66 males/24 females) with mean age of 26.4years were enrolled in our study. Majority of patients were Omani nationals (85.5%) followed by expatriates (14.5%) with 64 (71.1 %) patients presenting within 03-06 hrs of injury to hospital. Maximum number of injuries 46 (51.1%) were observed during time interval from 07 am to 05 pm during months of September and November. Majority of patients numbering 37 sustained injuries while at work (machine injuries /fall of heavy objects) followed by household and motor vehicle accident (MVA) related injuries. Highest percentage of injuries was observed in household workers 28 (31.2%) followed by unskilled workers 23 (25.5%). The Little finger (25.6%) and ring finger (21.1%) were most commonly injured digits. Distal phalanx was the most commonly involved region of finger. Combined injuries along with Open fractures and dislocations accounted for majority of injuries seen in our study.Final results were good in 44 (48.9%) with moderate grade of HISS in 48 (53.3%) cases.

Conclusion: Hand injuries in this part of world are mainly occupational related injuries which to great extent are preventable. Proper education, training at work place with proper safety measures will help in preventing large number of such injuries.