Return to work after traumatic hand injury – a prospectiv cohort study with two years follow up

Background: Hand injuries account for a high proportion of the traumatic injuries seen in emergency rooms, and they have significant personal and societal costs. In this master´s thesis relevant prognostic factors with... [ view full abstract ]

Background: Hand injuries account for a high proportion of the traumatic injuries seen in emergency rooms, and they have significant personal and societal costs. In this master´s thesis relevant prognostic factors with assumed significance for the opportunity to get back into paid work is investigated. In addition, the prognostic factors' impact on hand function is also investigated.

Method: Prospective cohort study with quantitative monitoring of a population of 87 patients with severe traumatic hand injury. Different injury, function, surgical and demographic variables were examined in multivariate logistic regression analyses.

Results: The main findings are that the patient's self-reported decreased function of the hand/arm, as reported in the questionnaire QuickDASH at 12 months, is a significant predictor of employment status at 24 months. Cold sensitivity in the hand and/or arm is the factor that has the greatest effect on the patient's self-reported function two years after injury.

Discussion: In the present studies on traumatic hand injuries and predictors of future employment participation, the theoretical basis is inconclusive. Some studies have found an association between severity of injury and the likelihood of returning to work. Other studies find that the causes are individual or that workplace and work participation is a complex area with many factors. In this study one finds a basis for the patient's self-reported function questionnaire QuickDASH being a good starting point to clarify who may be at risk of not returning to work.

Keyword: Traumatic Hand injury, Prognostic, Return to Work (RTW), handfunction, participation, QuickDASH.