Davas Aksan Aslı, Durusoy Raika, Ada Sait, Kayalar Murat, Aksu Feride, Bal Emin
Ege University Faculty of Medicine, Department of Public Health, İzmir, Turkey.
Acta Orthop Traumatol Turc. 2010;44(5):352-60. doi: 10.3944/AOTT.2010.2372.
The aim of this study was to evaluate the epidemiology of injuries treated at a hand and microsurgery hospital between 1992 and 2005.
This is a descriptive retrospective study based on medical records of a hand and microsurgery hospital in İzmir 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).
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 İzmir 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% confidence 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
Hand injuries are important because of their consequences, such as permanent disability 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 occupational 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.
本研究旨在评估1992年至2005年间一家手外科和显微外科医院所治疗损伤的流行病学情况。
这是一项基于伊兹密尔一家手外科和显微外科医院1992 - 2005年病历的描述性回顾性研究。共纳入涉及8817例患者的8946例损伤。诊断数据根据国际疾病分类第10版（ICD - 10）记录。受伤意图、受伤时的活动、损伤机制、致伤物体/物质以及受伤地点根据国际损伤外部原因分类（ICECI）进行重新编码。
最常见的损伤类型是手腕和手部的截肢（32.3%）、骨折（23.7%）和开放性伤口（19.9%）。大多数损伤发生在男性身上；28.4%的损伤发生在夏季。根据活动情况，76.3%的损伤发生在有偿工作期间，10.4%发生在交通期间，9.1%发生在无偿工作期间，3.8%发生在休闲时间的体育和锻炼期间。损伤最常发生在操作机器时。35岁以下人群、男性、伊兹密尔省以外的人员以及社会保障机构（SSI）参保工人发生手部损伤的风险升高（p<0.001）。手部损伤风险最高的活动是有偿工作。与基线相比，在工业或建筑区域手部损伤风险是基线的29倍[95%置信区间（CI）16.36 - 50.40]，在商业场所是基线的50倍（95% CI 17.29 - 143.96）。
手部损伤因其诸如永久性残疾等后果以及高昂的治疗费用而很重要。本研究指出了许多重要的风险因素，并有助于提出关于损伤类型、职业损伤报告不足和童工问题的假设。将此类专科医院的病历纳入国家数据库将有助于预防这些损伤，并推动诊断和治疗的发展。
