Work-Related Crushing Injuries with Amputations of Digits, Hands and Forearms

Abstract

Objective To review work-related crushing injuries leading to amputation of digits, hands and forearms, by focusing on patients' demographics, and clinical outcomes. Design Retrospective descriptive study. Setting Regional hospital, Hong Kong. Patients Patients with work-related crushing injuries causing amputation of digits, hands or forearms admitted to hospital for treatment from January 2003 to August 2005. Methods Patients' age, sex, past medical history, occupations, context of injuries including injuring objects and levels of amputation were studied. During a 9-month follow up period, patients' need for urgent operation, length of hospital stay, duration of sick leave and change of occupational status were analysed. Results Eighty-eight patients were studied. The age distribution ranged from 19 to 81 years, with 50% being less than 40 years of age. Most patients (93%) were healthy adult before the injury. Industries frequently involved were construction (24%), manufacturing (17%) and transportation (14%). Machineries and metallic tools were the most common injuring objects. Eighty-four percent of the amputation injuries involved the finger(s), and 13% the thumb. Most patients (91%) required urgent operation. The mean length of hospital stay was 4 days. The mean duration of sick leave was 152 days. The estimated wage loss was around HK$145,000 per accident. Only 42% of the patients could fully resume working without job restriction. Conclusion Traumatic amputation as a severe work-related injury is common in Hong Kong. It frequently affects the young and healthy workforce, resulting in devastating physical and psychological disabilities. The clinical, social and economical significances are enormous and far-reaching.