Mind your hand during the energy crunch: Functional Outcome of Circular Saw Hand Injuries.
BACKGROUND
Although injuries due to circular saws are very common all over the world, there is surprisingly little information available about their functional outcomes. As the socioeconomic impact of these injuries is immense and determined by the casualties' disability and impairment, it is the objective of this study to present data on the functional outcome, disability, and impairment of hand injuries due to electric circular saws.


METHODS
Patients treated from 1999 through 2007 for circular saw-related hand injuries were contacted and asked for clinical follow-up assessment. The clinical follow-up protocol consisted of a physical examination and an assessment of static muscle power (grip and pinch strength). For assessment of the subjective experience of the patients regarding their injury-related disability and impairment, the DASH follow-up questionnaire was used. The occupational impact of these injuries was measured by number of lost working days. Finally, safety-related behaviour of the patients was investigated.


RESULTS
114 Patients were followed-up on average 52 months after the injury. Average in-house treatment was 8.8 days. Average time lost from work was 14.8 weeks. A significant reduction of static muscle testing parameters compared with the uninjured hand was revealed for grip strength, tip pinch, key pinch, and palmar pinch. Average DASH score was 17.4 (DASH work 15.8, DASH sports/music 17.7). Most patients had more than ten years experience in using these power tools.


CONCLUSIONS
The everyday occurrence of circular saw-related hand injuries followed by relatively short periods of in-house treatment might distort the real dimension of the patients' remaining disability and impairment. While the trauma surgeon's view is generally confined to the patients' clinical course, the outcome parameters in this follow-up investigation, with loss of working time as the key factor, confirm that the whole socioeconomic burden is much greater than the direct cost of treatment.
Frank
Matthias
M
Department of Trauma and Orthopedic Surgery, Emergency Department, Ernst-Moritz-Arndt-University, Sauerbruchstr,, 17475 Greifswald, Germany. matthias.frank@uni-greifswald.de.
Hecht
Juliane
J
Napp
Matthias
M
Lange
Joern
J
Grossjohann
Rico
R
Stengel
Dirk
D
Schmucker
Uli
U
Ekkernkamp
Axel
A
Hinz
Peter
P
J Hand Surg Am. 2009 May-Jun;34(5):886-9
19410992
J Trauma. 2009 Sep;67(3):617-23
19741410
J Trauma. 2011 Dec;71(6):1902-7
20065881
Plast Reconstr Surg. 2006 Jan;117(1):186-9
16404265
Z Rechtsmed. 1982;89(3):173-80
7158079
Am J Ind Med. 2003 May;43(5):539-42
12704627
J Hand Surg Br. 2005 Dec;30(6):588-92
16140441
J Forensic Sci. 2008 Jul;53(4):965-7
18489556
Ann Thorac Surg. 2009 Sep;88(3):985-7
19699935
Percept Mot Skills. 2003 Jun;96(3 Pt 1):728-30
12831245
Am J Occup Ther. 2001 Mar-Apr;55(2):206-11
11761137
J Rheumatol. 1990 Aug;17(8):1022-4
2213777
Injury. 1981 Mar;12(5):417-24
7263053
Arch Phys Med Rehabil. 1985 Feb;66(2):69-74
3970660
Phys Ther. 1996 Mar;76(3):248-59
8602410
J Hand Surg Eur Vol. 2007 Aug;32(4):394-9
17399870
Injury. 2006 Nov;37(11):1071-7
17045996
Unfallchirurg. 2003 Jan;106(1):13-9
12552388
Forensic Sci Int. 2010 May 20;198(1-3):74-8
20116188
J Hand Surg Br. 1999 Apr;24(2):187-9
10372773
J Trauma. 2008 Jan;64(1):170-3
18188117
J Hand Surg Am. 2008 Apr;33(4):558-65
18406961
J Hand Surg Am. 1984 Mar;9(2):222-6
6715829
J Plast Reconstr Aesthet Surg. 2007;60(7):704-9
17466610