Hand injuries in young children

Detta är en avhandling från Elinor Ljungberg, Department of Hand Surgery, Malmö University Hospital

Sammanfattning: The proportion of hand injuries in Swedish children is the second highest in relation to other parts of the body. The incidence of hand injuries in these children has not yet been estimated. In addition, aetiologies, injury patterns and costs among Swedish children have not been presented on a regional or national level. Also, very few studies have focused on hand injuries within specific ages for children internationally. The aim of this thesis was to gather information regarding incidences, aetiologies, injury patterns and costs of hand injuries in Swedish children, particularly between the ages of 0 and 6 years. Children referred for treatment at the Department of Hand Surgery in Malmö, Sweden, during 1996-2000 and 2002-2003, were analysed as to incidence, injury patterns, aetiologies and costs through hospital notes and a questionnaire. Information about all children with a primary hand injury, admitted to Swedish hospitals during 1987-2001, was retrieved from the Swedish Hospital Discharge Register, and analysed as to incidence and in order to identify risk groups. The incidence of young Swedish children with hand injuries referred for treatment or follow up was 27/10 000 children/year in Malmö, and the hospitalised young children with hand injuries in Sweden were 4/10 000 children/year. An increase over time, for unknown reasons, was found in Malmö between 1996 and 2000, and nationally between 1987 and 2001. Young girls are only 0.64 times as likely as boys to suffer hand injuries. However, finger amputations are about as common among girls as boys. National background does not have an impact on the occurrence. The leading types of injuries and etiological factors varied across the ages. Fingertip injuries, caused by jamming in doors, were common in all ages, and occurred predominantly in home settings. Despite a modest cost per case (about EUR 2 500), frequent fingertip injuries in young children generated large total health care costs. In contrast, complex hand injuries are unusual among young children, but bring substantial cost per case, and may cause permanent disability. Generally, the cost from lost productivity is small (14%). Non-fatal injuries to the paediatric hand may become important to politicians and authorities when incidences and costs are considered. Presented data of aetiologies and injury patterns may be utilized to improve prevention strategies, with the purpose to decrease incidences of hand injuries in children.