Epidemiological patterns and preventability of traumatic hand amputations among adults in Greece

Abstract

IntroductionHand/finger amputations though rare account for significant disability and health-related costs; yet, information on underlying causes, springing mostly from physicians’ reports, is rather anecdotal. We sought to draw attention to the high preventable fraction of hand/finger amputations among adults in Greece. Patients and MethodsData on external cause of injury and short-term outcome, recorded over nine years in the Emergency Department Injury Surveillance System (EDISS) were analysed, whereas sample weights were used for nationwide extrapolations. ResultsHand/finger injuries accounted for 20.4% (N=57,986) among 284,705 injuries recorded in patients >14-year-old (3% annual probability); 728 (1.3%) resulted in amputations; the estimated incidence rate (IR) was 39.3/100,000 person-years, reaching a high 92.6/100,000 among males aged 45–64 years. As expected, the vast majority of victims were males (90%), frequently young immigrants; ∼two-thirds sustained occupational injuries during working hours. Objects most frequently involved included: machinery (57% overall/69% occupational), means of transport (10.4%), materials (9.5%), parts of buildings/furniture (5%). Wood-working was the most common risk factor (20% overall/28% occupational) whereas 6% of victims accepted own inattention. 30% of amputations were hospitalised whereas 10% transferred to specialised units. DiscussionSpecialised registries reveal the magnitude and specific causes of disabling hand injuries and point to tailored national injury prevention programs; specifically in Greece, as they occur in more controlled occupational environments among middle-aged males, woodworkers, and are caused mainly by machinery. ConclusionsIncreased management of safety in the workplace could play a role in reduction in hand amputations.