1) Occupational hand injuries are a major problem in Pakistan, accounting for over 10% of emergency department visits, compared to less than 10% in developed countries. 2) These injuries range from minor cuts and abrasions to amputations, and outcomes depend on the severity of injury and quality of treatment received. 3) Several interventions are recommended to address this preventable issue, including implementing safety protocols at workplaces, educating workers, establishing rehabilitation services, and improving medical care for injured workers.

1. Occupational Hand Trauma Muhammad Saaiq
Ann. Pak. Inst. Med. Sci. 2007; 3(4): 204-5 204
Editorial
Occupational Hand Trauma: Can we
do Something to Reduce the Sufferings
of our Poor Workers?
Muhammad Saaiq*
Department of Plastic Surgery
PIMS, Islamabad.
Address for Correspondence:
Dr Muhammad Saaiq
Department of Plastic Surgery
PIMS, Islamabad.
E-mail:
muhammadsaaiq5@gmail.com
The hand is a highly perfect and intricate tool
with which man has been endowed with by his creator. It
receives information from the outside world and then the
individual acts upon it. It also translates human intellect
into meaningful communications in the form writings and
fine skilled voluntary movements involved in a variety of
professions. Indeed following brain, hand is the second
most frequently used organ of human body. Owing to its
function it is vulnerable to various traumatic insults.
Unfortunately the incidence of occupational
hand injuries is disconcertingly high in our set up owing
to the recognized limitations of our workplace
environments. Contrary to this, hand injuries account for
no more than 10% of all emergency department
presentations in the developed countries.1,2
The spectrum of occupational hand trauma
ranges from minor cuts and abrasions to more
devastating injuries such as traumatic amputation of the
fingers or hand. The magnitude of injury depends upon
the mechanism of injury, circumstances under which the
injury ensued, availability of on-scene medical care and
accessibility to specialist care. Adequate professional
training on part of the sufferer helps to reduce the
severity of injury. The injury may involve bones or soft
tissues or both. 3, 4
The outcome of occupational hand trauma
depends not only on the severity of injury but also on the
adequacy of timely instituted treatment. The outcome
is generally good, however some patients have
prolonged periods of reduced functionality and disability
with significant socioeconomic implications. A plastic
surgeon would focus on the following priorities:
preserving viability by restoring circulation, obtaining
good soft tissue coverage, alignment and stabilization of
skeleton, restoration of nerve function, mobilization of
joints and restoration of tendon function. Close co-
ordination between the surgeon and hand therapist is
essential for good rehabilitation of these patients. 4, 5
Certain key interventions are required to
address this largely preventable issue. We would
make the following recommendations in this
regard:
1) All doctors, public health authorities, governmental
and non-governmental organizations should make
collaborative efforts to address this challenging
issue of grave implications.
2) At national level, a hand injury prevention
programme should be launched. It should ensure
active participation of the community as well as
health care providers. It should aim at motivating the
various stakeholders, creating public awareness
and imparting education on injury prevention
strategies.
3) Media should play its due role in creating public
awareness about the significant consequences of
this preventable problem. It should launch
awareness programmes in local languages to help
the poor and uneducated manual workers and
labourers.
4) For all industrial, agricultural, electrical and other
manual workers well planned codes and
occupational safety protocols should be developed
to prevent hand trauma at workplaces. Adequate
training of all labourers and manual workers should
be made mandatory on the employers.
5) Legislators and parliamentarians should play their
role by formulating laws to ensure that the various
industries and commercial organizations employ
only trained staff and fulfill their responsibility of
strictly adhering to the occupational safety
protocols.
6) Those who sustain occupational hand injuries
should receive adequate specialized hand care.

2. Occupational Hand Trauma Muhammad Saaiq
Ann. Pak. Inst. Med. Sci. 2007; 3(4): 204-5 205
Plastic surgeons with interest in the area of hand
should play their role in this regard. Their dedicated
services can help reduce the miseries of these
patients.
7) Rehabilitation of the hand trauma victims continues
to be a largely neglected area in our set up. The
subject should be included in the curriculum of both
undergraduate and postgraduate studies and
incentives be offered to those who own it as a
career. Efforts should also be made to establish
proper Rehabilitation centres for hand trauma
victims.
References
1. Lese AB. Hand Injury, Soft Tissue (Serial online) 2006 August
(Cited 2008 Jan 03 ): (4 screens) . Available from : URL :
http://www.emedicine.com/emerg/topic225.htm
2. Khan AZ, Khan IZ, Khan A, Akhter J, Choudhry AM. Audit of
occupational hand trauma presenting in the Accident and emergency
departments of two major hospitals. Ann King Edward Med Coll
1998;4:14-6.
3. Campbell DA. Hand fractures. Surgery International 2006; 75 : 437-
40.
4. Jones NW, Laing H. Acute injuries to the flexor and extensor tendons
of the hand. Surgery International 2006; 75 : 441-5.
5. Tymchak J. Soft tissue reconstruction of the hand. In: Thorne CH,
Beasley RW, Aston SJ, Bartlett SP, Gurtner GC, Spear SL, editors.
Grabb and Smith’s Plastic surgery. 6th ed. Philadelphia: Lippincott
Williams and Wilkins; 2007: 771-80.