The Management Outcome of Acute Hand Injury in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia

Abstract

Background: Hand is the most commonly injured part of our body. The aim of treatment is always to restore its movement, strength and dexterity. The quality of primary treatment often determines the maximal potential for recovery. The objective of this study was to evaluate the management outcome and consequences of the injured hand.

Methods: Between 1^st January 2005 and 31^st December 2005, a total of 253 patients were treated in Tikur Anbessa University Hospital for acute hand injury that presented within the first 24 hours of the occurrence. We evaluate the mechanism of injury, types and duration of treatments and complications.

Results: The mean age was 32 years and the male to female ratio was 7:1. The majority of patients were wood worker (32%) followed by laborers (25%) and machine operators (15%). Three quarter of the injuries occurred at work, of which 74% were caused by machines. The commonest injuries included fracture in 39% of which the majority (85%)mwere compound, amputation in 31% and soft tissue injury in 26%. The injury severity was moderate and above in 54%. Most were managed at emergency out-patient department and the average total treatment time was 93 days. The average impairment of hand function before and after treatment was 6% and 19% respectively. The main reason for more loss of function after treatment were more proximal corrective amputation (31%), prolonged immobilization (28%) in nonfunctional position (17%), healed in unacceptable position (19%) and infection (13%). Final results were poor in 62%, this was not significantly associated with severity of the injury.

Conclusion: Improving treatment of injured hand and establishing specialized center for hand injury may shorten duration of treatment and improve result.