Hand amputations: epidemiology, management and resurfacing options for soft tissue coverage

Area of Science:

• Orthopedics
• Trauma Surgery
• Epidemiology

Background:

• Agricultural hand injuries are a significant concern, particularly affecting young adults and impacting their socioeconomic well-being.
• These injuries often result in loss of function in the dominant hand, hindering work and social activities.

Purpose of the Study:

• To investigate the epidemiology of agricultural hand injuries in Indian subjects.
• To analyze the management strategies and outcomes of these injuries.

Main Methods:

• A retrospective study was conducted in India from October 2009 to December 2013.
• Data on socio-demographics, injury type, surgical reconstruction, complications, and hospital stay were collected and analyzed.

Main Results:

• Young adults of lower socioeconomic status were most affected, with injuries often occurring during harvest seasons.
• Wheat thresher injuries (51%) and fodder cutting machine injuries (36%) were the most common causes, particularly among females and children.
• Reverse radial forearm flaps were optimal for regional coverage, while thoraco-umbilical flaps were common distant flaps; single-stage procedures shortened hospital stays.

Conclusions:

• While not entirely preventable, agricultural hand injuries can be reduced through education, though socioeconomic factors pose challenges.
• Forearm flaps are versatile for hand reconstruction, promoting early discharge and rehabilitation.
• Abdominal flaps serve as effective coverage for associated forearm injuries.