Associations between initial injury severity in acute hand, wrist or forearm injuries and disability ratings and time to return to work

BACKGROUND: This study aimed to examine the relationships between the initial anatomic severity of hand, wrist and forearm injuries, as evaluated by the Modified Hand Injury Severity Score (MHISS), and each of the following parameters: disability rating and time to return to work.
METHODS: In this study, 94 patients who underwent operations due to acute hand, wrist and forearm injuries were included. MHISS was used to assess the severity of the injury. Disability rates of the patients were calculated six months after injury in accordance with the ‘Regulation on Disability Criteria, Classification and Health Board Reports to be Given to Disabled People’. The time to return to work was defined as the length of time (in days) between the injury and the patient’s return to work. Spearman rank correlation analysis was performed to analyse correlations between the MHISS and each of the following: disability rates and time to return to work.
RESULTS: The mean overall MHISS was 125.23 (5–880). The mean overall upper extremity disability ratio (UEDR) was 17.64±22.6 (range: 0–94), and the mean overall total body disability ratio (TBDR) was 10.57±13.45 (range: 0–56). Among the study population, 87 (92.6%) patients were able to return to their jobs. The mean overall time to return to work was 138.69 (range: 35–365 days). A statistically significant correlation was found between MHISS and UEDR, TBDR and time to return to work and UEDR, TBDR (p<0.001).
CONCLUSION: As a result, as the initial injury severity increased, greater disability remained and the time to return to work increased. Predicting prognosis by determining the injury severity in the initial evaluation of patients may be important in predicting a patient’s future permanent disability level, which can contribute to maintaining patient expectations at a reasonable level, thereby aiding in psychosocial support.

Akut el, el bileði ya da ön kol yaralanmalarýnda yaralanmanýn ciddiyeti ile özürlülük oranlarý ve iþe geri dönüþ zamaný arasýndaki iliþki

AMAÇ: Modifiye El Yaralanmasý Ciddiyet Skoru (MEYCS) ile deðerlendirilen el, el bileði ve ön kol yaralanmalarýnýn baþlangýçtaki anatomik þiddeti ile yaralanma sonrasý özürlülük oranlarý ve iþe geri dönüþ zamaný arasýndaki iliþkiyi araþtýrmaktýr.
GEREÇ VE YÖNTEM: Çalýþmaya akut el, el bileði ve önkol yaralanmasý nedeniyle ameliyat edilen 94 hasta alýndý. Yaralanmanýn þiddeti MEYCS ile belirlendi. Yaralanmadan 6 ay sonra hastalarýn özürlülük oranlarý ‘Özürlülük Ölçütü, Sýnýflandýrmasý ve Özürlülere Verilecek Saðlýk Kurulu Raporlarý Hakkýnda Yönetmelik’e göre hesaplandý. Ýþe geri dönüþ süresi, yaralanma ile hastanýn iþe geri dönüþü arasýndaki sürenin (gün) uzunluðu olarak tanýmlandý. MEYCS ile özürlülük oranlarý ve iþe geri dönüþ zamaný arasýndaki iliþki Sperman korelasyon analizi ile araþtýrýldý.
BULGULAR: Ortalama MEYCS; 125.23 (5–880), üst ekstremite özürlülük oraný (ÜEÖO);17.64±22.6 (daðýlým: 0–94) ve total vücut özürlülük oraný (TVÖO); 10.57±13.45 (daðýlým: 0–56) olarak bulundu. Çalýþmaya dahil edilen 87 (92.6%) hasta eski iþine geri döndü. Ortalama iþe geri dönüþ zamaný; 138.69 (daðýlým: 35–365 gün) olarak bulundu. MEYCS ile ÜEÖO ve TVÖO arasýnda, iþe geri dönüþ zamaný ile ÜEÖO ve TVÖO arasýnda istatiksel olarak anlamlý bir korelasyon bulundu (p<0.001).
TARTIÞMA: Sonuç olarak, yaralanmanýn baþlangýçtaki þiddeti arttýkça hastalarýn özürlülük oranlarý ve iþe geri dönüþ zamanlarý artmaktadýr. Hastalarýn ilk deðerlendirmesinde yaralanmanýn ciddiyetini saptayarak prognoz hakkýnda ön görüye sahip olmak hastalarýn gelecekteki kalýcý sakatlýk seviyesini tahmin etmede ve böylelikle hasta beklentilerinin makul düzeyde tutulmasý saðlanarak psikososyal destek açýsýndan önemli olabilir.