Probability of spacesuit-induced fingernail trauma is associated with hand circumference

A significant number of astronauts sustain hand injuries during extravehicular activity training and operations. These hand injuries have been known to cause fingernail delamination (onycholysis) that requires medical intervention. This study investigated correlations between the anthropometrics of the hand and susceptibility to injury.

The analysis explored the hypothesis that crewmembers with a high finger-to-hand size ratio are more likely to experience injuries. A database of 232 crewmembers' injury records and anthropometrics was sourced from NASA Johnson Space Center.

No significant effect of finger-to-hand size was found on the probability of injury, but circumference and width of the metacarpophalangeal (MCP) joint were found to be significantly associated with injuries by the Kruskal-Wallis test. A multivariate logistic regression showed that hand circumference is the dominant effect on the likelihood of onycholysis.

Male crewmembers with a hand circumference > 22.86 cm (9") have a 19.6% probability of finger injury, but those with hand circumferences < or = 22.86 cm (9") only have a 5.6% chance of injury. Findings were similar for female crewmembers. This increased probability may be due to constriction at large MCP joints by the current NASA Phase VI glove. Constriction may lead to occlusion of vascular flow to the fingers that may increase the chances of onycholysis. Injury rates are lower on gloves such as the superseded series 4000 and the Russian Orlan that provide more volume for the MCP joint. This suggests that we can reduce onycholysis by modifying the design of the current gloves at the MCP joint.