Department of Plastic Surgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India.
J Hand Surg Asian Pac Vol. 2022 Apr;27(2):267-275. doi: 10.1142/S2424835522500382. Epub 2022 Mar 31.
Crush injuries of the hand sustained from sugarcane juice extracting machines have a unique mechanism of injury and clinical presentation. The severity of the injury can vary from simple skin lacerations to mangling of the hand. We devised a classification for these injuries based on the severity level that has helped with the management. The aim of this study is to determine whether the classification correlates with patient rated outcome score at 6 months. We prospectively studied 30 consecutive patients with a sugarcane crusher injury of the hand. The patients were classified into Class I, II, III or IV based on our classification and managed accordingly. Patient outcomes were assessed at 6 months after the injury, using the Michigan Hand Outcomes Questionnaire (MHQ). Spearman's rank correlation test was used to analyse the correlation between the different classes of hand injury and functional outcomes at 6 months following injury (measured using MHQ). The study included 6 patients (20%) with Class I injury, 11 patients (36.6%) with Class II, 9 patients (30%) with Class III and 4 patients (13.4%) with Class IV injury. The mean MHQ scores at 6-month follow-up were 72.3% in Class I, 62.1% in Class II, 52.9% in Class III and 32% in Class IV injuries. An inversely proportional association between the severity grade as per the classification and MHQ scores was noted. Our proposed classification of sugarcane crusher injuries of the hand correlates well with the MHQ score. The use of the classification can help with management and predicting prognosis. In addition, wider use will permit comparison of outcomes between different centres. Level IV (Therapeutic).
甘蔗压榨机所致手部挤压伤具有独特的损伤机制和临床表现。损伤的严重程度可从简单的皮肤裂伤到手部严重毁损伤。我们根据损伤严重程度设计了一种分类方法，有助于进行管理。本研究旨在确定该分类是否与患者在 6 个月时的自评结果评分相关。我们前瞻性研究了 30 例连续的手部甘蔗压榨机损伤患者。根据我们的分类，患者分为 I 类、II 类、III 类或 IV 类，并进行相应的治疗。患者在受伤后 6 个月使用密歇根手功能问卷（Michigan Hand Outcomes Questionnaire，MHQ）进行功能评估。采用 Spearman 秩相关检验分析不同手损伤分级与受伤后 6 个月功能结果（用 MHQ 评估）之间的相关性。研究包括 6 例（20%）I 级损伤、11 例（36.6%）II 级损伤、9 例（30%）III 级损伤和 4 例（13.4%）IV 级损伤。I 级损伤患者在 6 个月时的 MHQ 评分平均为 72.3%，II 级损伤为 62.1%，III 级损伤为 52.9%，IV 级损伤为 32%。根据分类的严重程度等级与 MHQ 评分之间呈反比关系。我们提出的甘蔗压榨机所致手部挤压伤分类与 MHQ 评分相关性良好。该分类的使用有助于管理和预测预后。此外，更广泛的应用将允许比较不同中心之间的结果。IV 级（治疗）。
