Ozçelik Bülent, Ertürer Erden, Mersa Berkan, Purisa Hüsrev, Sezer Ilker, Tunçer Serdar, Kabakaş Fatih, Kuvat Samet Vasfi
İst-el Hand Surgery, Microsurgery and Rehabilitation Group, İstanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2012 Jan;18(1):49-54. doi: 10.5505/tjtes.2011.45656.
The aim of this study was to construct an alternative classification system for occupational hand injuries based on etiologic mechanisms and to analyze the injury patterns resulting from various mechanisms.
A retrospective analysis of patients operated between January 2005 and December 2007 in two hand surgery units staffed by a team of hand surgeons was made. The patient files were retrospectively examined, and mechanisms causing the injuries were analyzed. Similar mechanisms were classified in the same groups, and the mechanism of injury was matched with type of injury often caused by this mechanism. In the classification of injuries, the tissues that were injured were taken as a basis for classification. 4120 upper extremity injuries were seen in the study hospitals, and 2188 (53.1%) of them were occupational injuries. There were 2063 males (94.3%) and 125 females (6.7%). The mean age was 28.2 (range: 15-71) years.
Examination of the agents causing injury yielded 62 agents. Further examination of these agents showed that the mechanism by which they caused injury was similar in some agents, and these agents were placed in the same groups, which constituted the Etiologic Classification of Hand Injuries (ECOHI) classification. These groups of mechanisms were: cutting-penetrating, cutting-crushing, crushing-penetrating, crushing-compressing, crushing-burning, stinging, avulsing, electrical current, and chemical injuries and miscellaneous burns. The two most common mechanisms were crushing-compressing and cutting-crushing types, constituting 744 (34.0%) and 514 (23.5%) of injuries, respectively.
We believe that ECOHI is important to form a common language for the classification of etiologic factors.
本研究的目的是基于病因机制构建一种职业性手部损伤的替代分类系统，并分析各种机制导致的损伤模式。
对2005年1月至2007年12月期间在两个由手外科医生团队工作的手外科科室接受手术的患者进行回顾性分析。对患者病历进行回顾性检查，并分析导致损伤的机制。将相似的机制归为同一组，并将损伤机制与该机制常导致的损伤类型相匹配。在损伤分类中，以受伤的组织作为分类依据。研究医院共诊治了4120例上肢损伤，其中2188例（53.1%）为职业性损伤。男性2063例（94.3%），女性125例（6.7%）。平均年龄为28.2岁（范围：15 - 71岁）。
对致伤因素的检查发现了62种因素。对这些因素的进一步检查表明，其中一些因素导致损伤的机制相似，这些因素被归为同一组，构成了手部损伤病因分类（ECOHI）。这些机制组包括：切割 - 穿透、切割 - 挤压、挤压 - 穿透、挤压 - 压缩、挤压 - 烧伤、蜇伤、撕脱伤、电流伤、化学伤和杂类烧伤。两种最常见的机制是挤压 - 压缩型和切割 - 挤压型，分别占损伤的744例（34.0%）和514例（23.5%）。
我们认为ECOHI对于形成病因因素分类的通用语言很重要。
