Background Traumatic hand and finger amputations frequently lead to permanent disability.
Objective To investigate their epidemiological characteristics and estimate the prevention potential among children 0–14 years old, through a cross-sectional survey.
Methods Nationwide extrapolations were produced based on data recorded between 1996 and 2004 in the Greek Emergency Department Injury Surveillance System and existing sample weights. Incident and injury related characteristics were analysed to identify preventable causes.
Results Among 197 417 paediatric injuries, 28 225(14%) involved the hand and fingers resulting in 236 amputations (∼1% of hand injuries). The annual probability to seek emergency department care for a hand injury was 3%. The estimated incidence rate (IR) of hand amputations was 19.7/100 000 person-years. Over 50% concerned children 0–4 years old (male:female=2:1), peaking at 12–24 months. Male preschoolers suffered the highest IR (38.7/100 000). Migrant children were overrepresented among amputees. Of all amputations, 64% occurred in the house/garden and 14% in day-care/school/sports activities, usually between 08:00 and 16:00 (61%). Doors were the product most commonly involved (55% overall; 72% in day-care/school/gym) followed by furniture/appliances (15%) and machinery/tools (7%). Crushing was the commonest mechanism. Inadequate supervision and preventive measures were also frequently reported. 5% of the amputees were referred to specialised units for replantation/reconstructive surgery.
Conclusions The majority of paediatric hand and finger amputations could be prevented in Greece, particularly among preschoolers, by a single product modification, namely door closure systems, coupled with improved supervision. Paediatricians should incorporate this advice into their routine child-safety counselling. This country-specific profile supports the need for maintaining similar databases as an indispensable tool for assisting decision-making and preventing disabling and costly injuries.
- burden of disease
- injury surveillance systems
- multiple injury
- public health
- trauma systems
- descriptive epidemiology
- medical error
- hand injury
- product modification
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Funding This project was supported in part by the Ministry of Health and Welfare of Greece (grant no. 2003ΣM09100000). EDISS was also partly funded by the European Union (DG SANCO–grant agreement number 2003313 (SI2.379687)). Role of the funder: MOHAW provided financial support and facilitated establishment of the EDISS in the collaboration hospitals and financial as well as technical support DG-SANCO provided support within the framework of the project ‘Coordination and Administration of the European Injury Prevention Working Party on Accidents and Injuries Program’.
Competing interests None.
Patient consent All patients before the interview gave informed consent for use of the information they provided.
Ethics approval Ethics approval was provided by Bioethics Committee of the University of Athens Medical School.
Provenance and peer review Not commissioned; externally peer reviewed.