Major traumatic injuries of the hand and forearm - epidemiology, health-economic aspects, functional impairment and life quality

The incidence of hand injuries varies between 7-37/1000 inhabitants and year and the extent of the injuries varies. It has been reported that around 66% of the patients are injured during leisure time, 15% in their home and only 14% are injured during work which is far from different around 50 years ago where the work related injuries were around 50%. The majority of the patients are young men and most of the injuries are minor, usually not generating large costs for society even if they can induce loss of production, i.e. sick leave. However, more extensive injuries like crush injuries, amputations, and tendon and nerve injuries may require large resources within the health care sector leading to a long sick leave thereby generating high costs. The rehabilitation period can be very long since extensive hand injuries induce hinder of function thereby affecting the patient's activity of daily living. The classification shaped by World Health Organisation (WHO) to describe health and health related conditions in humans, such as the international classification for functioning, disability and health (ICF), is used as a framework. We use it to thoroughly study patients (e.g. epidemiology, healt and costs) with particularly major severe hand and forearm injuries in prospective studies running for several years. With a battery of clinical tests and questionnaires impairment of function and self-reported disability are investigated, including factors influencing return to work and the patients' strategies to cope with the injury. In this context the patients' self confidence is crucial. In these studies several institutes and departments are involved, e.g. Health Economy (Katarina Steen-Carlsson) and Department of Health Sciences (Eva Ramel).