Prediction of hand function after occupational hand injury by evaluation of initial anatomical severity

Abstract

Purpose: To examine the relationship between initial anatomic severity evaluated by the Hand Injury Severity Scoring (HISS) system and recovered hand function evaluated by the Purdue Pegboard after occupational hand injury.

Method: In the retrospective cohort study, 95 patients hospitalized between 1 January 2000 and 31 December 2003 for surgery due to occupational hand injury were recruited. The HISS scores were obtained by chart review by a surgeon. The Purdue Pegboard was performed at least 6 months after the injury by well-trained occupational therapists. The Purdue Pegboard scores were compared with the initial HISS scores by simple regression, multiple regression and logistic regression analysis.

Results: The total HISS score was negatively correlated with scores of the Purdue Pegboard subtests, including injured-hand, both-hands, and assembly. The risk of having low injured-hand score (<13) was significantly increased in workers with initial major severity (HISS >or= 101), with OR 9.57 (95% CI 1.4-94.8). The risk of having low both-hands score (<10) was significantly increased in workers with initial severe and major severity (HISS of 51-100 and >or=101), with OR 4.5 (95% CI 1.1-21.8) and OR 25 (95% CI 3.5-263). The risk of having low assembly score (<25) was significantly increased in workers with initial major severity (HISS >or= 101), with OR 9.0 (95% CI 1.3-72.5).

Conclusion: The study showed that after occupational hand injury, initial anatomic severity evaluated by the HISS system could predict hand function after recovery.