Socio-economic effects of hand injuries in adults and children

Hand injuries of varying severity may affect children and young adults with most of their professional life in the future. It is important to study hand injuries in children and adults both in regional and in national studies with the purpose to prevent such injuries and their effects on the individual patient. An increased knowledge about hand injuries, that can generate long sick leave, can be used to create more effective rehabilitation programs and thereby decrease the time for sick leave after hand injuries. In retrospective and prospective studies, we focus on epidemiological mapping of hand injuries in children and adults. During a five year period we have noticed a large increase in the incidence of hand injuries in young children in Malmö. Such an increase is also seen in a national study of hospitalised children consisting of around 10000 Swedish children treated for a hand injury during the last 15 years. A thesis is earlier presented by Elinor Ljungberg (2008).

There are few studies that describe the epidemiology of hand injuries in adults, particularly analysing costs within the health care system and costs caused by loss of production. Fifty years ago few injuries occurred during leisure time but nowadays around 1/3 of the injuries occur during leisure time, 1/3 at home and only around 1/3 during work. Most of the hand injuries affect young adults with a mean age of 28 years and around 4% of the hand injuries leads to such serious consequences for the injured patient that there will be a severe functional impairment in the future leading to costs due to loss of production, retirement and other costs for society. For example, a flexor tendon injury in a finger generates costs of around 15000€, while a median nerve injury in the distal forearm have a total cost of around 50000€. Around 85% of the costs are due to loss of production. Many different factors can affect such costs. Active rehabilitation of a flexor tendon injury increases the costs, but also significantly improve results (range of motion). We are currently studying a variety of injuries with respect to outcome and costs. In all the studies about socio-economic effects of hand injuries, we have a close and intense collaboration with Katarina Steen-Carlsson, Health Economy, Lund and Malmö.